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Images in Paediatrics
Unusual suprasternal mass
Masa supraesternal inusual
Ignacio Aldana Villamañána, María Aldana Villamañánb, Javier González Llorentec, Javier Aldana Gómezd,
Corresponding author
jaldanag@hotmail.com

Corresponding author.
a Hospital Clínico Universitario de Valladolid, Valladolid, Spain
b Hospital Universitario, Torrejón de Ardoz, Madrid, Spain
c Servicio de Radiología, Hospital Recoletas, Segovia, Spain
d Servicio de Pediatría, Hospital Recoletas, Segovia, Spain
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    "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&#44; which had not been observed before&#44; with no associated symptoms or previous history of disease&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the physical examination&#44; the Valsalva manoeuvre revealed a noncompressible suprasternal mass measuring 5<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cm that disappeared at the end of the manoeuvre &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#44; Appendix B&#44; Video in supplemental material&#41;&#46;</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&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This case is atypical and rare&#44; as the mass appeared intermittently in the context of increasing intrathoracic pressure&#46; This narrowed down the potential diagnoses<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#58; apical lung herniation &#40;compressible&#44; crepitus&#41;&#44; laryngocoele &#40;adults&#44; possible stridor or dyspnoea&#41;&#44; jugular phlebectasia &#40;compressible and usually lateral&#41; and thymic herniation &#40;suprasternal&#44; more frequent between ages 3 and 5 years&#44; when the thymus is largest&#44; not compressible&#44; silent on auscultation&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Sonography is the gold standard for imaging and usually sufficient&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> In this case&#44; the ultrasound examination detected superior herniation of the thymus &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; This quick and safe diagnosis made other procedures involving radiation&#44; biopsy or surgery unnecessary&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;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&#44; there was no need for surgical resection or any other treatment&#46;</p></span>"
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ISSN: 23412879
Original language: English
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Idiomas
Anales de Pediatría (English Edition)