Image in Cardiology
Lung adenocarcinoma: The diagnostic importance of echocardiography
Adenocarcinoma do pulmão: importância diagnóstica da ecocardiografia
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Image 1: T1 sequence. Image 2: T2 sequence. Image 3: T2 STIR sequence. Image 4: Fat saturation sequences. Image 5: Early enhancement sequence. Image 6: Late enhancement sequences. Images 7 and 8: Exuberant adenopathy conglomerates highlighted with an asterisk.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rui Files Flores, Fernando Guilherme Mané, Vítor Hugo Pereira, Catarina Vieira" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Rui Files" "apellidos" => "Flores" ] 1 => array:2 [ "nombre" => "Fernando Guilherme" "apellidos" => "Mané" ] 2 => array:2 [ "nombre" => "Vítor Hugo" "apellidos" => "Pereira" ] 3 => array:2 [ "nombre" => "Catarina" "apellidos" => "Vieira" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123003839?idApp=UINPBA00004E" "url" => "/08702551/0000004300000003/v2_202403080630/S0870255123003839/v2_202403080630/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Lung adenocarcinoma: The diagnostic importance of echocardiography" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "147" "paginaFinal" => "148" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Inês Ferreira Neves, Pedro Garcia Brás, Pedro Coelho, Paulo Calvinho, Luísa Branco" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Inês" "apellidos" => "Ferreira Neves" "email" => array:1 [ 0 => "inessferreiraneves@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Pedro" "apellidos" => "Garcia Brás" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 2 => array:2 [ "nombre" => "Pedro" "apellidos" => "Coelho" ] 3 => array:2 [ "nombre" => "Paulo" "apellidos" => "Calvinho" ] 4 => array:2 [ "nombre" => "Luísa" "apellidos" => "Branco" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Cardiology, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Adenocarcinoma do pulmão: importância diagnóstica da ecocardiografia" ] ] "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" => 2027 "Ancho" => 3458 "Tamanyo" => 480107 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Transthoracic echocardiogram (TTE) with an image suggestive of a cardiac mass with protrusion to the left atrium (LA) (red arrow); (B) TEE with an exuberant tumoral mass in the right inferior pulmonary vein (RIPV) with protrusion of 2.8 cm into the LA (yellow arrow); apparent surgical cleavage plane in the LA (blue arrow); area without surgical cleavage plane (green arrow); lung carcinoma (white arrow); (C) (coronal plane) and (D) (axial plane): chest computed tomography scan showing lung carcinoma (red arrow) invading the LA (yellow arrow).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 44-year-old man with poorly differentiated lung adenocarcinoma (stage IV, T4N0M1a) was referred for a transthoracic echocardiogram (TTE) to assess for cardiac metastasis. Although there were no signs of left atrial invasion in parasternal and apical views, subcostal view on the TTE showed an image suggestive of a cardiac mass, with protrusion to the left atrium (LA) through the right inferior pulmonary vein (RIPV) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A and <a class="elsevierStyleCrossRef" href="#sec0015">Video 1</a>). There were no other abnormal findings on the TTE. To clarify the extension of the cardiac mass, a transesophageal echocardiogram (TEE) was performed, revealing an exuberant tumoral mass in the RIPV, measuring 8.2 cm, with protrusion of 2.8 cm into the LA (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B and <a class="elsevierStyleCrossRef" href="#sec0015">Video 2)</a>. Despite an apparent surgical cleavage plane in the LA, the cardiac mass showed complete invasion of the RIPV wall (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B). There were no masses adjacent to the left pulmonary veins. A chest computed tomography (CT) scan confirmed tumor invasion through the RIPV (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C and D). The patient then underwent successful surgical tumorectomy of the lung and RIPV mass and atrioplasty. The postoperative course was uneventful.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cardiac metastasis from lung carcinomas is rare.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> TTE is a crucial initial imaging modality as it can detect cardiac invasion to the pericardium or through the pulmonary veins.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2,3</span></a> However, a high level of suspicion is needed, as a thorough scan may uncover minor findings that should prompt further imaging. CT, cardiac magnetic resonance imaging and positron emission tomography can provide further information on differential diagnosis of the mass.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2–4</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-05-31" "fechaAceptado" => "2023-07-04" "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">These authors contributed equally to this work.</p>" "identificador" => "fn0005" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0025" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0015" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2027 "Ancho" => 3458 "Tamanyo" => 480107 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Transthoracic echocardiogram (TTE) with an image suggestive of a cardiac mass with protrusion to the left atrium (LA) (red arrow); (B) TEE with an exuberant tumoral mass in the right inferior pulmonary vein (RIPV) with protrusion of 2.8 cm into the LA (yellow arrow); apparent surgical cleavage plane in the LA (blue arrow); area without surgical cleavage plane (green arrow); lung carcinoma (white arrow); (C) (coronal plane) and (D) (axial plane): chest computed tomography scan showing lung carcinoma (red arrow) invading the LA (yellow arrow).</p>" ] ] 1 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 488041 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 2 => array:5 [ "identificador" => "upi0010" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc2.mp4" "ficheroTamanyo" => 201045 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc2.flv" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc2.m4v" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastatic cardiac tumors: from clinical presentation through diagnosis to treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "I. Burazor" 1 => "S. Aviel-Ronen" 2 => "M. Imazio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12885-018-4070-x" "Revista" => array:5 [ "tituloSerie" => "BMC Cancer" "fecha" => "2018" "volumen" => "18" "paginaInicial" => "202" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29463229" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac masses: an integrative approach using echocardiography and other imaging modalities" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D. Auger" 1 => "J. Pressacco" 2 => "F. Marcotte" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/hrt.2010.196006" "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "2011" "volumen" => "97" "paginaInicial" => "1101" "paginaFinal" => "1109" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21642661" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac masses, part 1: imaging strategies and technical considerations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "O. Buckley" 1 => "R. Madan" 2 => "R. Kwong" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "2011" "volumen" => "197" "paginaInicial" => "W837" "paginaFinal" => "W841" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tumors metastatic to the heart" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.D. Goldberg" 1 => "R. Blankstein" 2 => "R.F. Padera" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.112.000790" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2013" "volumen" => "128" "paginaInicial" => "1790" "paginaFinal" => "1794" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24126323" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000004300000003/v2_202403080630/S0870255123004559/v2_202403080630/en/main.assets" "Apartado" => array:4 [ "identificador" => "93357" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Case Report" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004300000003/v2_202403080630/S0870255123004559/v2_202403080630/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123004559?idApp=UINPBA00004E" ]
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