Images in Paediatrics
Unusual suprasternal mass
Masa supraesternal inusual
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=> array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Universitario, Torrejón de Ardoz, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Radiología, Hospital Recoletas, Segovia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Recoletas, Segovia, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Masa supraesternal inusual" ] ] "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" => 675 "Ancho" => 1005 "Tamanyo" => 81735 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0140" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Frontal view. Left: no evidence of a suprasternal mass with the patient at rest. Right: appearance of a suprasternal mass with performance of the Valsalva manoeuvre, which did not cause pain, aphonia, dysphagia or dyspnoea.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A girl aged 5 years presented with a suprasternal mass that appeared on crying starting 10 days prior, which had not been observed before, with no associated symptoms or previous history of disease.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the physical examination, the Valsalva manoeuvre revealed a noncompressible suprasternal mass measuring 5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm that disappeared at the end of the manoeuvre (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>, Appendix B, Video in supplemental material).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Cervical masses require early and accurate diagnosis because they may be signs of severe disease.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This case is atypical and rare, as the mass appeared intermittently in the context of increasing intrathoracic pressure. This narrowed down the potential diagnoses<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>: apical lung herniation (compressible, crepitus), laryngocoele (adults, possible stridor or dyspnoea), jugular phlebectasia (compressible and usually lateral) and thymic herniation (suprasternal, more frequent between ages 3 and 5 years, when the thymus is largest, not compressible, silent on auscultation).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Sonography is the gold standard for imaging and usually sufficient.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> In this case, the ultrasound examination detected superior herniation of the thymus (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). This quick and safe diagnosis made other procedures involving radiation, biopsy or surgery unnecessary.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Since the patient was asymptomatic and this type of herniation tends to resolve as the size of the thymus decreases, there was no need for surgical resection or any other treatment.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-02-10" "fechaAceptado" => "2023-03-20" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0035" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0010" ] ] ] ] "multimedia" => array:4 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 675 "Ancho" => 1005 "Tamanyo" => 81735 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0140" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Frontal view. Left: no evidence of a suprasternal mass with the patient at rest. Right: appearance of a suprasternal mass with performance of the Valsalva manoeuvre, which did not cause pain, aphonia, dysphagia or dyspnoea.</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" => 707 "Ancho" => 805 "Tamanyo" => 60266 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0145" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Lateral view of the suprasternal mass during the Valsalva manoeuvre. The mass was not compressible, there was no crepitus and was silent on auscultation.</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" => 1469 "Ancho" => 1005 "Tamanyo" => 213980 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0150" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ultrasound image of the suprasternal region during the Valsalva manoeuvre. Top: axial plane. Bottom: sagittal plane. Both show thymic tissue with normal sonographic characteristics with suprasternal herniation (white arrows).</p>" ] ] 3 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 1757937 "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 ] ] ] ] ] "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" => "Timo cervical aberrante: masa cervical pediátrica inusual, revisión bibliográfica y reporte de un caso" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Loreto Álvarez" 1 => "R. Carolina Sepúlveda" 2 => "G. Aníbal Espinoza" 3 => "G. Matías Gómez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Otorrinolaringol Cir Cabeza Cuello" "fecha" => "2020" "volumen" => "80" "paginaInicial" => "69" "paginaFinal" => "74" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intermittent midline suprasternal neck mass caused by superior herniation of the thymus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Choo Su" 1 => "T. Hess" 2 => "A. Whybourne" 3 => "A.B. Chang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jpc.12744" "Revista" => array:6 [ "tituloSerie" => "J Paediatr Child Health" "fecha" => "2015" "volumen" => "51" "paginaInicial" => "344" "paginaFinal" => "346" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25266888" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Superior herniation of the mediastinum presenting as an anterior neck mass on straining" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.M. McDougall" 1 => "G. Culham" 2 => "M.D. Seear" 3 => "M.A. Chilvers" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pediatric Pulmonol" "fecha" => "2012" "volumen" => "47" "paginaInicial" => "710" "paginaFinal" => "717" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009900000004/v1_202310060818/S2341287923002028/v1_202310060818/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/23412879/0000009900000004/v1_202310060818/S2341287923002028/v1_202310060818/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923002028?idApp=UINPBA00005H" ]
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