Image in Cardiology
Cardiac metastasis of primary bronchial carcinoid
Carcinóide brônquico primário com metastização miocárdica
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array:24 [ "pii" => "S2174204921001926" "issn" => "21742049" "doi" => "10.1016/j.repce.2021.07.023" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "1740" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2021;40:523-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:20 [ "pii" => "S087025512100189X" "issn" => "08702551" "doi" => "10.1016/j.repc.2020.09.011" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "1740" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2021;40:523-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Cardiac metastasis of primary bronchial carcinoid" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "523" "paginaFinal" => "524" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Carcinóide brônquico primário com metastização miocárdica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1998 "Ancho" => 2007 "Tamanyo" => 320302 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Right lower panel: Cardiac magnetic resonance imaging showing two rounded, well-defined intramyocardial high signal intensity lesions in T2-weighted sequences, at the medium and distal segments of the anterolateral wall (dark arrow). These two lesions showed isosignal intensity in T1-weighted images, and intense early (upper right panel, dashed arrow) and late (lower left panel, white arrows) gadolinium enhancement; Upper left panel: Positron emission tomography image shows increased <span class="elsevierStyleSup">68</span>Ga-DOTATOC uptake, further supporting the anatomic correspondence of these foci.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro Gonçalves-Teixeira, Ricardo Ladeiras-Lopes, Nuno Dias Ferreira" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Pedro" "apellidos" => "Gonçalves-Teixeira" ] 1 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Ladeiras-Lopes" ] 2 => array:2 [ "nombre" => "Nuno" "apellidos" => "Dias Ferreira" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204921001926" "doi" => "10.1016/j.repce.2021.07.023" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204921001926?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025512100189X?idApp=UINPBA00004E" "url" => "/08702551/0000004000000007/v1_202107090532/S087025512100189X/v1_202107090532/en/main.assets" ] ] "itemAnterior" => array:20 [ "pii" => "S2174204921001914" "issn" => "21742049" "doi" => "10.1016/j.repce.2021.07.022" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "1742" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2021;40:521-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Limited dissection in Kommerell diverticulum of aberrant right subclavian artery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "521" "paginaFinal" => "522" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Dissecção limitada em divertículo de Kommerell na artéria subclávia direita aberrante" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1205 "Ancho" => 1505 "Tamanyo" => 297484 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography angiography of the aorta, axial view (A), multiplanar reformatting in sagittal view (B), and volume rendering in oblique posterior views (C-E). Focal bulging of 21 mm×8 mm with a ‘mushroom cap’ appearance at a Kommerell diverticulum of the aberrant right subclavian artery (yellow arrows in A and B, black arrows in C-E). The latter compresses the esophagus posteriorly along its course to the right and passes 8 mm posterior to the right posterolateral margin of the trachea. The aortic size is within normal range and no other structural abnormalities of the aorta are observed. Note that vascular repair at this location may entail technical difficulties, particularly anchoring the endoprosthesis at the origin of the right subclavian artery. In addition, total exclusion of the dissected segment cannot always be achieved.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antonio Jesús Láinez-Ramos-Bossini, Eduardo Ruiz-Carazo" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Antonio Jesús" "apellidos" => "Láinez-Ramos-Bossini" ] 1 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Ruiz-Carazo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255121001918" "doi" => "10.1016/j.repc.2020.06.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121001918?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204921001914?idApp=UINPBA00004E" "url" => "/21742049/0000004000000007/v1_202107150708/S2174204921001914/v1_202107150708/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Cardiac metastasis of primary bronchial carcinoid" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "523" "paginaFinal" => "524" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Pedro Gonçalves-Teixeira, Ricardo Ladeiras-Lopes, Nuno Dias Ferreira" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Pedro" "apellidos" => "Gonçalves-Teixeira" "email" => array:1 [ 0 => "pedromgoncalvesteixeira@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Ricardo" "apellidos" => "Ladeiras-Lopes" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Nuno" "apellidos" => "Dias Ferreira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Cardiology Department, Gaia Hospital Center, Vila Nova de Gaia, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Carcinóide brônquico primário com metastização miocárdica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1998 "Ancho" => 2007 "Tamanyo" => 320302 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Right lower panel: Cardiac magnetic resonance imaging showing two rounded, well-defined intramyocardial high signal intensity lesions in T2-weighted sequences, at the medium and distal segments of the anterolateral wall (dark arrow). These two lesions showed isosignal intensity in T1-weighted images, and intense early (upper right panel, dashed arrow) and late (lower left panel, white arrows) gadolinium enhancement; Upper left panel: Positron emission tomography image shows increased <span class="elsevierStyleSup">68</span>Ga-DOTATOC uptake, further supporting the anatomic correspondence of these foci.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 46-year-old male was referred to the cardio-oncology clinic for comprehensive cardiovascular assessment. He had a medical history of bronchial carcinoid, having undergone left pneumonectomy 20 years earlier, and was diagnosed with stage IV disease (bone and liver metastasis). A <span class="elsevierStyleSup">68</span>Ga-DOTATOC positron emission tomography (PET) scan in July 2019 was notable due to two foci of abnormally high radionuclide uptake at the left inferolateral aspect of the cardiac silhouette (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, upper left panel).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">He had no cardiovascular symptoms. Clinical examination was unremarkable. The electrocardiogram showed sinus rhythm with no ST-T abnormalities. Transthoracic and transesophageal echocardiograms revealed no relevant structural or functional abnormality. Cardiac magnetic resonance imaging (MRI) showed two rounded, well-defined intramyocardial high signal intensity lesions in T2-weighted sequences, at the medium and distal segments of the anterolateral wall (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, right lower panel, dark arrow). These two lesions showed isosignal intensity in T1-weighted images, and intense early (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, right upper panel, dashed arrow) and late (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, left lower panel, white arrows) gadolinium enhancement. The anatomic correspondence between PET and cardiac MRI lesions led to diagnosis of cardiac metastasis of primary bronchogenic carcinoid.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Carcinoid tumors are uncommon neuroendocrine (NE) neoplasms that produce high levels of serotonin. These tumors are more frequently found in the gastrointestinal tract but are primary bronchial in about one quarter of cases. Carcinoid heart disease (CHD) can occur in up to 50% of cases, more often with right-sided valve disease, a consequence of NE mediators progressively seeding over valvular and subvalvular structures, with progressive thickening and dysfunction. Approximately 4% of CHD cases present with cardiac metastasis, with lesions being mostly described as rounded, homogeneous intramyocardial masses. Depending on their functional and/or symptomatic repercussion, along with size considerations, surgical resection may be indicated.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-08-12" "fechaAceptado" => "2020-09-13" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1998 "Ancho" => 2007 "Tamanyo" => 320302 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Right lower panel: Cardiac magnetic resonance imaging showing two rounded, well-defined intramyocardial high signal intensity lesions in T2-weighted sequences, at the medium and distal segments of the anterolateral wall (dark arrow). These two lesions showed isosignal intensity in T1-weighted images, and intense early (upper right panel, dashed arrow) and late (lower left panel, white arrows) gadolinium enhancement; Upper left panel: Positron emission tomography image shows increased <span class="elsevierStyleSup">68</span>Ga-DOTATOC uptake, further supporting the anatomic correspondence of these foci.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000004000000007/v1_202107150708/S2174204921001926/v1_202107150708/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000004000000007/v1_202107150708/S2174204921001926/v1_202107150708/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204921001926?idApp=UINPBA00004E" ]
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