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La imagen B muestra la misma tumoración 2 meses después. Se caracteriza por numerosas lesiones tuberosas-polipoideas de color rojo oscuro y con apariencia en «racimo de uvas» que ocupan la mucosa vulvar y protruyen a través del introito vaginal.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mariona Morell Daniel, María Rosario Pérez-Torres Lobato, Miriam Morey Olivé, Luis Gros Subias" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Mariona" "apellidos" => "Morell Daniel" ] 1 => array:2 [ "nombre" => "María Rosario" "apellidos" => "Pérez-Torres Lobato" ] 2 => array:2 [ "nombre" => "Miriam" "apellidos" => "Morey Olivé" ] 3 => array:2 [ "nombre" => "Luis" "apellidos" => "Gros Subias" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287923000534" "doi" => "10.1016/j.anpede.2022.03.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" 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telangiectatic rim.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Inés María Bermejo Rodríguez, Ana María Márquez Armenteros, Elena Del Castillo Navío, Ana Izquierdo Martín" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Inés María" "apellidos" => "Bermejo Rodríguez" ] 1 => array:2 [ "nombre" => "Ana María" "apellidos" => "Márquez Armenteros" ] 2 => array:2 [ "nombre" => "Elena" "apellidos" => "Del Castillo Navío" ] 3 => array:2 [ "nombre" => "Ana" "apellidos" => "Izquierdo Martín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403322001242" "doi" => "10.1016/j.anpedi.2022.04.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403322001242?idApp=UINPBA00005H" ] ] "EPUB" => 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"paginaInicial" => "315" "paginaFinal" => "316" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Trastorno linfoproliferativo bajo apariencia de foliculitis por mascarilla" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1409 "Ancho" => 1100 "Tamanyo" => 193338 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Plaque measuring about 3 × 3 cm in the malar region.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Álvaro Vázquez-Pérez, David López-Delgado, Francisco 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"https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923000522?idApp=UINPBA00005H" "url" => "/23412879/0000009800000004/v2_202304070152/S2341287923000522/v2_202304070152/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Malignant vaginal tumor: About a case" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "317" "paginaFinal" => "318" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Mariona Morell Daniel, María Rosario Pérez-Torres Lobato, Miriam Morey Olivé, Luis Gros Subias" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Mariona" "apellidos" => "Morell Daniel" "email" => array:1 [ 0 => "mariona.morell@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "María Rosario" "apellidos" => "Pérez-Torres Lobato" ] 2 => array:2 [ "nombre" => "Miriam" "apellidos" => "Morey Olivé" ] 3 => array:2 [ "nombre" => "Luis" "apellidos" => "Gros Subias" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Oncología y Hematología Pediátricas, Hospital Vall d’Hebron, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumoración maligna vaginal: a propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1660 "Ancho" => 3017 "Tamanyo" => 378753 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Image A shows a polypoid lesion of 2 weeks’ duration. Image B shows the same mass 2 months later. Mass characterised by multiple dark red polypoid-tuberous lesions with a grape cluster appearance occupying the vulvar mucosa and protruding through the introitus.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a girl aged 2 years presenting with a growing genital mass (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A), leukorrhea and intermittent bleeding of 2 weeks’ duration, without constitutional symptoms. The examination revealed a gelatinous polypoid mass with a grape cluster appearance (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). The tumour was surgically resected, the histological findings were compatible with botryoid rhabdomyosarcoma (desmin+, vimentin+, Ki67 30%, HHF35+) and metastasis was ruled out. The patient was treated per protocol (ISRG group <span class="elsevierStyleSmallCaps">iii</span>) with 15 cycles of chemotherapy with vincristine, actinomycin and cyclophosphamide and adjuvant pelvic floor radiotherapy, which achieved complete remission.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Rhabdomyosarcoma is the most frequent malignancy of the female genital tract in the paediatric age group.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The botryoid subtype is a variant of embryonal rhabdomyosarcoma that appears in girls aged less than 5 years in the vulvovaginal region, among others.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> The differential diagnosis includes germ cell tumours, clear cell sarcoma, urethral prolapse and ureterocoele.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Imaging can help distinguish between these lesions, although the diagnosis is confirmed by histological methods (tissue positive for vimentin and markers of myoid differentiation, such as actin antibody HHF35, desmin and myoglobin, and histological appearance characterised by alternating areas of hypocellularity and hypercellularity in a myxoid/oedematous stroma forming a <span class="elsevierStyleItalic">cambium</span> layer under the epithelium<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>). Treatment consists of surgery, polychemotherapy and radiotherapy,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and the 5-year survival for localized tumours is of 80%.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Therefore, the presence of a rapidly growing mass in the genital region with a grape-like appearance should trigger suspicion in the paediatrician, given the importance of early diagnosis.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1660 "Ancho" => 3017 "Tamanyo" => 378753 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Image A shows a polypoid lesion of 2 weeks’ duration. Image B shows the same mass 2 months later. Mass characterised by multiple dark red polypoid-tuberous lesions with a grape cluster appearance occupying the vulvar mucosa and protruding through the introitus.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vaginal tumors in childhood: the experience of St. Jude Children’s Research Hospital" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Fernandez-Pineda" 1 => "S.L. Spunt" 2 => "L. Parida" 3 => "M.J. Krasin" 4 => "A.M. Davidoff" 5 => "B.N. Rao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpedsurg.2011.05.003" "Revista" => array:7 [ "tituloSerie" => "J Pediatr Surg [Internet]." 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"fecha" => "2021" "volumen" => "34" "paginaInicial" => "1750" "paginaFinal" => "1762" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009800000004/v2_202304070152/S2341287923000534/v2_202304070152/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009800000004/v2_202304070152/S2341287923000534/v2_202304070152/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923000534?idApp=UINPBA00005H" ]
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