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Actualización clínica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Vincenzo Cuccurullo, Giuseppe Danilo Di Stasio, Laura Evangelista, Andrea Ciarmiello, Luigi Mansi" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Vincenzo" "apellidos" => "Cuccurullo" ] 1 => array:2 [ "nombre" => "Giuseppe Danilo" "apellidos" => "Di Stasio" ] 2 => array:2 [ "nombre" => "Laura" "apellidos" => "Evangelista" ] 3 => array:2 [ "nombre" => "Andrea" "apellidos" => "Ciarmiello" ] 4 => array:2 [ "nombre" => "Luigi" "apellidos" => "Mansi" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X17302366" "doi" => "10.1016/j.remn.2017.10.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X17302366?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808917301702?idApp=UINPBA00004N" "url" => "/22538089/0000003700000002/v1_201803020417/S2253808917301702/v1_201803020417/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical note</span>" "titulo" => "<span class="elsevierStyleSup">18</span>F-FDG PET/CT in a cardiac metastasis in a patient with history of malignant neuroectodermal tumour of the chest wall: Case report and review of the literature" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "110" "paginaFinal" => "113" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.A. Marroquín, A.C. Hernández, J.P. Pilkington, A. Saviatto, M.J. Tabuenca, J.M. Estenoz" "autores" => array:6 [ 0 => array:4 [ "nombre" => "J.A." "apellidos" => "Marroquín" "email" => array:1 [ 0 => "jaime_mg21@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A.C." "apellidos" => "Hernández" ] 2 => array:2 [ "nombre" => "J.P." "apellidos" => "Pilkington" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Saviatto" ] 4 => array:2 [ "nombre" => "M.J." "apellidos" => "Tabuenca" ] 5 => array:2 [ "nombre" => "J.M." "apellidos" => "Estenoz" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "12 de Octubre Hospital University, Nuclear Medicine Department, Avenida de Córdoba s/n, 28041 Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "PET/TC con <span class="elsevierStyleSup">18</span>F-FDG en metástasis cardíaca en un paciente con antecedente de tumor neuroectodérmico maligno de la pared torácica (tumor de Askin): caso clínico y revisión de la literatura" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 598 "Ancho" => 1600 "Tamanyo" => 101146 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">MRI showed a big intracardiac mass in the right cavities, mainly occupying the right atrium and partially the tricuspid valve ring.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Primary cardiac tumours are rare and mostly benign. Cardiac myxomas are the most common primary cardiac neoplasm in adults, approximately 20% of cases occur in the right atrium. The pathophysiology is unknown, some researchers have postulated that they result from overgrowth of trapped embryologic rests. A myxoma on the right side of the heart may cause pulmonary embolism, peripheral edema, hepatic congestion, and ascites, all attributable to the thrombotic nature of the mass and potential obstruction of systemic venous return. The definitive treatment is surgical resection.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Approximately 20%–25% of cardiac tumours are malignant. Sarcomas are the most common malignant primary cardiac neoplasm. On the other hand, secondary cardiac tumours, such as metastases to the heart from other malignant neoplasms can appear from the different primary tumours (in order of frequency of dissemination to the heart), being the most frequent a primary lung cancer, followed by hematological neoplasms, renal cancer and malignant melanomas.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Askin tumour is a malignant small round cell tumour originated as a primitive neuroectodermal tumour (PNET) belonging to the Ewing sarcoma family (ESF) due to its cytogenetic characteristics, and located in the thoracopulmonary region.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">PNET are rare, highly malignant and metastasises very fast with a poor prognosis. It usually develops in the soft tissues of the chest wall and occasionally in the mediastinum or the periphery of the lung. No standard guidelines are available for their treatment. It has been reported that surgery in combination with pre or post-operative chemo or radiotherapy is effective. The therapeutic guidelines for Ewing's sarcoma may be useful in guiding the treatment for PNET.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,6,7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">It may recur in the vicinity of the resected tumour (involving the ribs, pleura, chest wall muscles and diaphragm); and the metastases sites include lung, mediastinal and retroperitoneal lymph nodes, extrathoracic skeleton, liver, adrenal glands and sympathetic nerve chain.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> Metastasis to the heart is extremely uncommon.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Benign tumours can be resected completely in most cases. Therefore, it is important to differentiate between benign and malignant masses preoperatively. CT and MRI can depict several morphologic features that can be used to differentiate both of them. However today it is still difficult characterize correctly the cardiac tumours with sufficient accuracy. In contrast, molecular imaging methods such as <span class="elsevierStyleSup">18</span>F-FDG PET/CT can visualize tumour metabolism, being a clinically established method to characterize tumours.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0035" class="elsevierStylePara elsevierViewall">A 25-year-old male with history of malignant neuroectodermal tumour of the left chest wall (Askin tumour), treated with wide resection of the tumour in the anterior aspect of the chest wall and placing a mesh after neoadyuvant chemotherapy followed by consolidation chemotherapy. After 9 years of disease free survival, he developed an episode of acute pulmonary embolism, with a clinical presentation that included progressive dyspnea and chest pain. It was confirmed by thoracic tomography, also observing the presence of a cardiac mass.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The incidental finding of a cardiac mass was confirmed by echocardiogram and cardiac MRI (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), which revealed a mass in the right atrium. Askin tumour recurrence versus atrium myxoma was suspected.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">For oncologic PET/CT, a minimum of 6<span class="elsevierStyleHsp" style=""></span>h fasting is recommended to reduce normal myocardial uptake. However, in spite of adequate fasting, it often remains difficult to predict the degree of suppression of cardiac FDG uptake.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> It is also described in the literature that using heparin showes cardiac lesions more clearly, because it suppresses normal myocardial FDG uptake.</p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/CT showed an intense hypermetabolic right atrium mass with right ventricular extension (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), that suggested Askin tumour recurrence rather than atrium myxoma because of its intense metabolic activity. Abnormal <span class="elsevierStyleSup">18</span>F-FDG uptake was not observed in the rest of the body. The result of the pathological examination after biopsy by cardiac catheterization and subsequent exeresis of the right atrium mass by surgery was consistent with an Askin tumour metastasis. He is currently receiving consolidation chemotherapy, to complete his treatment.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG uptake reflects the metabolic rate of glycolysis in tumours and thus provides additional information to morphologic imaging. <span class="elsevierStyleSup">18</span>F-FDG PET/CT has become an important tool in the diagnosis and management of patients with malignant tumours, and on the other hand it provides the ability to differentiate between tumour and blood thrombus.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">PET/CT has proven to be useful in staging, response assessment to chemo or radiotherapy and recurrence detection in several tumours, like sarcomas. The interpretation of PET images in cardiac tumours can be challenging due to the physiological and unpredictable myocardial uptake. Unfortunately, this has not yet been systematically evaluated for the characterization of cardiac tumours.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6,9,10</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">CT is mainly recommended for the evaluation of extracardiac masses that infiltrate into the pericardium or the heart itself and detect calcifications; however, the extent of infiltration into the myocardium can best be appreciated in MRI. For both (MRI and CT), several features have been described to differentiate benign from malignant lesions, but neither feature alone are efficient enough to differentiate benign from malignant lesions.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Benign cardiac tumours are expected to show only slight <span class="elsevierStyleSup">18</span>F-FDG uptake, instead a high metabolic activity is present in malignant tumours (both primary and metastases). When an increased FDG uptake exists, fused PET/CT shows direct tumour invasion into the chest wall structures better than other imaging modalities. The ability to provide imaging in all three planes also helps to demonstrate the tumour metabolic extension of the disease and determine resectability. SUVmax measurements can help to successfully discriminate between benign and malignant tumours.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">In this case report, an Askin tumour metastasis versus an atrium myxoma was suspected, taking into account the characteristics of the mass and the medical history of the patient.</p><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/CT showed an intense metabolic uptake by the mass, with a high SUVmax that was suggestive of malignancy (primary or metastases) rather than myxoma which generally demonstrates very low or even no significant metabolic uptake. Regarding the preparation of our patient, 6<span class="elsevierStyleHsp" style=""></span>h fasting prior to performance PET/CT was enough, mainly due to the extent of the tumour.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Liwei et al. presented a similar case of a patient with a pulmonary primitive neuroectodermal tumour with a right atrium metastasis. They also mentioned that to date there have been only two case reports on pulmonary PNET affecting the heart, but both cases were due to direct propagation and infiltration from the primary tumour, instead of metastasis.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Qinghua et al. reviewed the case of a patient with pulmonary embolism caused by a right atrial myxoma shown on <span class="elsevierStyleSup">18</span>F-FDG PET/CT. In this particular case PET/CT images showed multiple lung nodules and abnormal FDG activity in the right atrium. The subsequent studies demonstrated that the multiple lung nodules were derived from pulmonary embolism of the right atrial myxoma. Right atrium myxoma should be considered as one of the differential diagnosis when the findings show mild increased FDG uptake.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">In our case, thanks to the findings of the <span class="elsevierStyleSup">18</span>F-FDG PET/CT we were able to identify and confirm the suspicion of recurrence in the right atrium at the same time that distant metastasis were discarded. This allowed the patient to receive a curative treatment (surgical exeresis of the right atrium mass), and subsequently he received consolidation chemotherapy to prevent more metastases in the future. After one year of follow up he is alive without evidence of tumour.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">No potential conflicts of interest were disclosed.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres993857" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec957252" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres993858" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec957251" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-01-23" "fechaAceptado" => "2017-04-25" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec957252" "palabras" => array:4 [ 0 => "<span class="elsevierStyleSup">18</span>F-FDG PET/CT" 1 => "Malignant neuroectodermal tumour of the chest wall" 2 => "Askin tumour" 3 => "Cardiac metastasis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec957251" "palabras" => array:4 [ 0 => "PET/TC <span class="elsevierStyleSup">18</span>F-FDG" 1 => "Tumor neuroectodérmico maligno de la pared torácica" 2 => "Tumor de Askin" 3 => "Metástasis cardíaca" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The case presented is a 25-year-old male with a malignant neuroectodermal tumour on the left chest wall (Askin tumour), treated with surgery after neoadyuvant chemotherapy and followed by consolidation chemotherapy. After 9 years of disease free survival, the patient developed an acute pulmonary embolism. The echocardiogram, thoracic CT, and cardiac MRI scans revealed a mass in the right atrium. Recurrence of an Askin tumour versus an atrium myxoma was suspected. <span class="elsevierStyleSup">18</span>F-FDG PET/CT showed an intense hypermetabolic right atrium mass with extension to the right ventricle highly suggestive of malignancy. The result of the histopathology examination after biopsy and subsequently exeresis of the right atrium mass was consistent with a metastasis of the primary tumour.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un varón de 25 años con tumor neuroectodérmico maligno de la pared torácica izquierda (tumor de Askin), tratado con cirugía después de tratamiento quimioterápico neoadyuvante y seguido por quimioterapia de consolidación. Después de 9 años libre de enfermedad, el paciente presenta un episodio de tromboembolismo pulmonar agudo. El ecocardiograma, la tomografía computarizada de tórax y la resonancia cardíaca evidenciaban una masa en la aurícula derecha. Se sospechó recidiva del tumor de Askin versus mixoma auricular. La PET/TC con <span class="elsevierStyleSup">18</span>F-FDG mostró una masa hipermetabólica en la aurícula derecha con extensión a la cavidad ventricular derecha, altamente sugestiva de malignidad. El resultado del examen anatomopatológico después de la biopsia y posteriormente a la exéresis de la masa auricular derecha fue compatible con metástasis del tumor primario.</p></span>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 598 "Ancho" => 1600 "Tamanyo" => 101146 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">MRI showed a big intracardiac mass in the right cavities, mainly occupying the right atrium and partially the tricuspid valve ring.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2081 "Ancho" => 1800 "Tamanyo" => 271708 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET, CT and fused PET/CT transaxial images (A), sagittal images (B) and coronal images (C), show intense focal <span class="elsevierStyleSup">18</span>F-FDG uptake in the right cardiac cavities (predominantly in the atrium), with a SUVmax of 14.27 (arrows). The MIP image (D) shows no other pathological foci in the body.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The right atrium: gateway to the heart anatomic and pathologic imaging findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.B. Malik" 1 => "D. Kwan" 2 => "A.B. Shah" 3 => "J.Y. Hsu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.351130010" "Revista" => array:6 [ "tituloSerie" => "RadioGraphics" "fecha" => "2015" "volumen" => "35" "paginaInicial" => "14" "paginaFinal" => "31" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25590385" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Differentiation of malignant and benign cardiac tumors using 18F-FDG PET/CT" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Rahbar" 1 => "H. Seifarth" 2 => "M. Schäfers" 3 => "L. Stegger" 4 => "A. Hoffmeier" 5 => "T. Spieker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2967/jnumed.111.095364" "Revista" => array:6 [ "tituloSerie" => "J Nucl Med" "fecha" => "2012" "volumen" => "53" "paginaInicial" => "856" "paginaFinal" => "863" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22577239" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How to differentiate benign versus malignant cardiac and paracardiac 18F-FDG uptake at oncologic PET/CT" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.H. Maurer" 1 => "M. Burshteyn" 2 => "L.P. Adler" 3 => "R.M. Steiner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.315115003" "Revista" => array:6 [ "tituloSerie" => "RadioGraphics" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "1287" "paginaFinal" => "1305" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21918045" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Askin tumor: four case reports and a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Q. Xu" 1 => "K. Xu" 2 => "C. Yang" 3 => "X. Zhang" 4 => "Y. Meng" 5 => "Q. Quan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1102/1470-7330.2011.0025" "Revista" => array:6 [ "tituloSerie" => "Cancer Imaging" "fecha" => "2011" "volumen" => "11" "paginaInicial" => "184" "paginaFinal" => "188" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22138531" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic accuracy of <span class="elsevierStyleSup">18</span>F-FDG-PET and PET/CT in patients with Ewing sarcoma family tumours: a systermatic review and a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Treglia" 1 => "M. Salsano" 2 => "A. Stefanelli" 3 => "M.V. Mattoli" 4 => "A. Giordano" 5 => "L. Bonomo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00256-011-1298-9" "Revista" => array:6 [ "tituloSerie" => "Skeletal Radiol" "fecha" => "2012" "volumen" => "41" "paginaInicial" => "249" "paginaFinal" => "256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22072239" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Askin's tumor in an adult: case report and findings on 18F-FDG PET/CT" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Kara Gedik" 1 => "O. Sari" 2 => "T. Altinok" 3 => "L. Tavli" 4 => "B. Kaya" 5 => "P. Ozcan Kara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2009/517329" "Revista" => array:2 [ "tituloSerie" => "Case Rep Med" "fecha" => "2009" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Askin tumor: CT and FDG-PET/CT imaging findings and follow-up" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Xia" 1 => "Y. Guan" 2 => "Y. Chen" 3 => "J. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MD.0000000000000042" "Revista" => array:2 [ "tituloSerie" => "Medicine" "fecha" => "2014" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rare pulmonary primitive neuroectodermal tumor metastasizing to the right atrium: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Mao" 1 => "H. Wang" 2 => "G. Xie" 3 => "N. Zhang" 4 => "G. Liao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12032-012-0200-5" "Revista" => array:6 [ "tituloSerie" => "Med Oncol" "fecha" => "2012" "volumen" => "29" "paginaInicial" => "2649" "paginaFinal" => "2653" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22392199" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac metastases of Edwing sarcoma detected by <span class="elsevierStyleSup">18</span>F-FDG PET/CT" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Coccia" 1 => "A. Ruggiero" 2 => "V. Rufini" 3 => "P. Maurizi" 4 => "G. Attinà" 5 => "R. Marano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MPH.0b013e318242754d" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Hematol Oncol" "fecha" => "2012" "volumen" => "34" "paginaInicial" => "236" "paginaFinal" => "238" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22395217" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary embolism caused by right atrial myxoma on FDG PET/CT" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Q. Liu" 1 => "C. Zuo" 2 => "T. Lv" 3 => "M.D.B. Cui" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0000000000000226" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2013" "volumen" => "38" "paginaInicial" => "928" "paginaFinal" => "930" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24089067" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003700000002/v1_201803020417/S2253808917302082/v1_201803020417/en/main.assets" "Apartado" => array:4 [ "identificador" => "34046" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical note" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003700000002/v1_201803020417/S2253808917302082/v1_201803020417/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808917302082?idApp=UINPBA00004N" ]
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Clinical note
18F-FDG PET/CT in a cardiac metastasis in a patient with history of malignant neuroectodermal tumour of the chest wall: Case report and review of the literature
PET/TC con 18F-FDG en metástasis cardíaca en un paciente con antecedente de tumor neuroectodérmico maligno de la pared torácica (tumor de Askin): caso clínico y revisión de la literatura
J.A. Marroquín
, A.C. Hernández, J.P. Pilkington, A. Saviatto, M.J. Tabuenca, J.M. Estenoz
Corresponding author
12 de Octubre Hospital University, Nuclear Medicine Department, Avenida de Córdoba s/n, 28041 Madrid, Spain