Images in Paediatrics
Newborn with elbow lump
Recién nacido con tumoración en el codo
Álvaro Cobreros-Péreza,
, Eva Pueyo-Agudob, Laura Almendro-Garcíac, María Jurado-Tabaresc
Corresponding author
a Unidad de Gestión Clínica de Neonatología, Hospital Materno-Infantil Regional Universitario de Málaga, Málaga, Spain
b Unidad de Gestión Clínica de Pediatría, Hospital Materno-Infantil Regional Universitario de Málaga, Málaga, Spain
c Unidad de Cirugía Pediátrica, Hospital Materno-Infantil Regional Universitario de Málaga, Málaga, Spain
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(B) Gradient echo T2-weighted image.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Male neonate born at 37 weeks of gestation, with no obstetric or maternal history of interest. The first physical examination revealed a mass in the right elbow (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), with no other abnormalities.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The infant was assessed in the paediatric surgery and radiology departments (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>), leading to diagnosis of a microcystic lymphatic malformation.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> Following a multidisciplinary evaluation, the decision was made to surgically remove the lesion with intraoperative neurophysiological monitoring at age 1.5 years. The histological examination of the specimen confirmed the suspected diagnosis, with detection of the D2 40 marker (+). No further abnormalities have been identified in the follow-up to date.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Lymphatic malformations, formerly known as lymphangiomas, are congenital malformations resulting from the obstruction of lymphatic vessels, usually in the cervical region.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3</span></a> It is rarely found in the upper extremities. Sonography<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> is useful for their diagnosis, as it can detect the presence of cysts. They rarely progress to malignant tumours. Watchful waiting is a controversial approach, as these masses rarely regress spontaneously.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> There are several options for medical management<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> (sirolimus, OK-432 or doxycycline) reserved for macrocystic malformations. However, surgical management<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> continues to be the most frequent approach, although the appropriate timing is still under debate: some authors recommend surgery at birth, and others after 1–2 years of life.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-04-12" "fechaAceptado" => "2022-06-09" "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1242 "Ancho" => 1262 "Tamanyo" => 220712 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mass in right elbow: soft mass measuring approximately 5 × 5 cm, unattached to deeper structures, absence of erythema or other cutaneous signs of inflammation.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2429 "Ancho" => 1741 "Tamanyo" => 263184 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ultrasound scan and plain radiograph of the lesion.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Ultrasound scan of the right upper extremity: multicystic lesion measuring 52 × 34 × 52 mm (CC × AP × TR), predominantly avascular, located in the subcutaneous tissue of the posterior elbow and extending into the adjacent compartments. No involvement of bone, joints or muscle tissue. (B) Plain radiograph of the right upper extremity showing a tumour in the right elbow.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 3513 "Ancho" => 1741 "Tamanyo" => 280098 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Magnetic resonance imaging of the lesion.</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">(A) Fat-suppressed proton density-weighted T1-weighted image. (B) Gradient echo T2-weighted image.</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" => "Elbow cystic lymphangioma in an 8-month-old boy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.J.H. Rahal" 1 => "M.R. Abou Al Ezz" 2 => "R.A. El Hajj" 3 => "J.Z. Chokor" 4 => "S.M. Nasser" 5 => "R.C. Moucharafieh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Case Rep Orthop." 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Garmpi" 4 => "G.A. Margonis" 5 => "E. Spartalis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Rev Med Pharmacol Sci." 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