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It is a nodular formation, measuring 5<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.6<span class="elsevierStyleHsp" style=""></span>cm with a smooth surface and areas of brown-violet coloration.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Epithelioid hemangioendothelioma is a vascular tumor of endothelial origin with an intermediate histological and clinical behavior somewhere between that of hemangiomas and angiosarcomas.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Its incidence is very low, and its most frequent location is at the hepatic and pulmonary level.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a> Its localization in the mediastinum is exceptional, and diagnosis is usually established after surgical treatment.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our patient is a 56-year-old woman with no medical history of interest who was sent to our consultation with the suspicion of a teratoma after thoracic CT performed due to pain in the right hemithorax. The CT scan revealed a 4-cm mass with fatty density and calcium in its interior located in the mediastinum. Thoracic MRI identified a 4-cm mass in the right anterior mediastinum with intralesional fatty foci and foci of hyposignal in related with calcifications. The mass was in contact with the brachiocephalic artery and with the right subclavian vein with no clear data of invasion (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a). By means of transverse cervicotomy, we proceeded with the exeresis of the mass. Post-operative evolution was satisfactory. The histologic report of the piece described a 5<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm mass with different mesenchymal components: mature-looking adipose tissue, fibroblastic fusiform cells, bone tissue with thick trabeculas in anarchic distribution and numerous capillary vessels covered with epithelioid endothelium (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b). The epithelioid cells showed an endothelial immunophenotype (CD 31 and CD 34 +). These findings supported the diagnosis of epithelioid hemangioendothelioma with an extensive metaplastic ossification. This result was confirmed by the Pathological Anatomy Department at Brigham and Women's Hospital in Boston (USA), reference center for the study of soft tissue tumors.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Epithelioid hemangioendothelioma usually presents in patients around the age of 40; the presentation is asymptomatic and is usually a coincidental radiological finding in half of patients.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In our case, the radiological suspicion was for a teratoma due to the calcifications observed on the imaging studies. Although its most frequent localization is at the hepatic and pulmonary level, other localizations have been reported in the mediastinum.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The histologic diagnosis with routine techniques is difficult, and it is necessary on the majority of occasions to use immunohistochemical techniques. In our case, we observed a large metaplastic ossification with positive epithelioid cells in the immunohistochemical study for CD 31 and CD 34, which coincides with the series by Suster et al. confirming the vascular origin of this type of tumor.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> As for prognosis and treatment, we should mention that it is a tumor with slow growth. The treatment of choice is surgical extirpation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Blanco M, et al. Hemangioendotelioma epitelioide mediastínico simulando un teratoma. Arch Bronconeumol. 2011;47:376–7.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2292 "Ancho" => 1736 "Tamanyo" => 288244 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Thoracic MRI where the mass is observed at the anterior mediastinal level; (b) macroscopic image of the resected mass. It is a nodular formation, measuring 5<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.6<span class="elsevierStyleHsp" style=""></span>cm with a smooth surface and areas of brown-violet coloration.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epithelioid hemangioendothelioma: a vascular tumor often mistaken for a carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.W. Weiss" 1 => "F.M. 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Irion" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2009.09.005" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2010" "volumen" => "46" "paginaInicial" => "103" "paginaFinal" => "104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19819604" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epithelioid hemangioendothelioma of the anterior mediastinum. Clinicopathologic, immunohistochemical, and ultrastructural analysis of 12 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Suster" 1 => "C.A. Moran" 2 => "M.N. Koss" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "1994" "volumen" => "18" "paginaInicial" => "871" "paginaFinal" => "881" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8067508" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000004700000007/v1_201305150530/S1579212911000164/v1_201305150530/en/main.assets" "Apartado" => array:4 [ "identificador" => "14576" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004700000007/v1_201305150530/S1579212911000164/v1_201305150530/en/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212911000164?idApp=UINPBA00003Z" ]
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2019 May | 30 | 16 | 46 |
2019 April | 68 | 26 | 94 |
2019 March | 38 | 21 | 59 |
2019 February | 33 | 17 | 50 |
2019 January | 18 | 18 | 36 |
2018 December | 26 | 22 | 48 |
2018 November | 62 | 15 | 77 |
2018 October | 116 | 24 | 140 |
2018 September | 26 | 12 | 38 |
2018 May | 12 | 0 | 12 |
2018 April | 49 | 5 | 54 |
2018 March | 52 | 4 | 56 |
2018 February | 73 | 6 | 79 |
2018 January | 109 | 12 | 121 |
2017 December | 93 | 5 | 98 |
2017 November | 26 | 8 | 34 |
2017 October | 19 | 10 | 29 |
2017 September | 28 | 10 | 38 |
2017 August | 49 | 16 | 65 |
2017 July | 31 | 6 | 37 |
2017 June | 42 | 12 | 54 |
2017 May | 40 | 7 | 47 |
2017 April | 35 | 7 | 42 |
2017 March | 22 | 65 | 87 |
2017 February | 19 | 5 | 24 |
2017 January | 9 | 6 | 15 |
2016 December | 34 | 9 | 43 |
2016 November | 43 | 12 | 55 |
2016 October | 52 | 22 | 74 |
2016 September | 50 | 13 | 63 |
2016 August | 62 | 18 | 80 |
2016 July | 36 | 7 | 43 |
2016 June | 0 | 12 | 12 |
2016 May | 0 | 11 | 11 |
2016 April | 0 | 2 | 2 |
2016 March | 2 | 2 | 4 |
2016 February | 2 | 2 | 4 |
2015 December | 3 | 0 | 3 |
2015 October | 44 | 3 | 47 |
2015 September | 35 | 11 | 46 |
2015 August | 30 | 5 | 35 |
2015 July | 30 | 5 | 35 |
2015 June | 28 | 6 | 34 |
2015 May | 34 | 7 | 41 |
2015 April | 25 | 7 | 32 |
2015 March | 23 | 8 | 31 |
2015 February | 36 | 6 | 42 |
2015 January | 25 | 3 | 28 |
2014 December | 31 | 6 | 37 |
2014 November | 32 | 7 | 39 |
2014 October | 31 | 6 | 37 |
2014 September | 24 | 8 | 32 |
2014 August | 35 | 9 | 44 |
2014 July | 17 | 9 | 26 |
2014 June | 37 | 11 | 48 |
2014 May | 44 | 9 | 53 |
2014 April | 43 | 7 | 50 |
2014 March | 53 | 11 | 64 |
2014 February | 41 | 8 | 49 |
2014 January | 38 | 6 | 44 |
2013 December | 34 | 14 | 48 |
2013 November | 27 | 7 | 34 |
2013 October | 32 | 7 | 39 |
2013 September | 28 | 13 | 41 |
2013 August | 24 | 10 | 34 |
2013 July | 39 | 8 | 47 |
2013 June | 17 | 6 | 23 |
2013 May | 6 | 1 | 7 |
2013 April | 14 | 3 | 17 |
2013 March | 5 | 2 | 7 |