Elastofibroma Dorsi: Clinicopathological Analysis of 76 Cases

Abstract

BackgroundWe aimed to investigate the epidemiological, clinical, paraclinical, and treatment aspects of elastofibroma dorsi through a retrospective study of 76 patients who underwent surgery between January 2008 and December 2012 in our department.MethodsOur study is retrospective between January 2008 and December 2012. We admitted 79 patients with a subscapular mass, and only 76 patients had ED. The others (n=2) had high associated risk of anesthesia and were managed by a medical treatment and one patient had a subscapular sclerotic hemangioma.ResultsThe average age of the patients was 49 years (range, 38 to 70 years), with a female predominance (54 females and 22 males). Subscapular location was constant. The right, left, and bilateral form was noted in 41, 15 and 20 cases, respectively. The diagnosis was clinical in 60 cases. Ultrasound and computerized tomography scans confirmed the diagnosis of an ill-defined mass in a subscapular location in all cases. Surgical treatment consisted of complete resection of the mass. The clinical diameter of the mass remained significantly lower than that of the surgical specimen (7 cm versus 12 cm) because the major hidden part of the mass in the subscapular area was inaccessible to palpation. Complications were noted in 9 cases (11.8%), seroma in 8 cases (10.5%), infection of wound site in 4 cases (5%), and parietal textilome in one case (1%). No case of recurrence was noted.ConclusionSurgery of elastofibroma is unique because of the subscapular location of the parietal tumor, whose histological fibrous nature makes it very adherent to the chest wall.

Elastofibroma dorsi: clinical experiences of 13 cases and review of the literature

“…Despite the fact that few cases related to this pathology were reached in the literature reviews, Brandser et al have reported this rate to be 2% in their studies of thoracic CT in asymptomatic elderly populations [2]. It is usually seen in the population over 55 years of age, however, there are some cases that are detected at younger ages [3,4]. It was reported that it is seen 8-13 times more among women than in men [2,3].…”

“…The frequency of bilateral occurrence of elastofibroma dorsi, which is usually observed unilaterally, is 10%. It is thought that bilateral cases are often synchronous [4,10]. More than 80% of elastofibroma dorsi are localized in the subscapular region, which is between the rhomboid and latissimus dorsi muscles and the sixth and eighth ribs.…”

“…The physiopathology is not exactly defined. It has been thought that the mechanical friction between the chest wall and scapula that develops after recurrent trauma plays a role in the development of these lesions [4]. Diagnostics include the ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI) methods [5].…”

Sonography of the chest wall: A pictorial essay

“…The hypoechoic tissue strands represent fat, and the hyperechoic tissue strands represent fibroelastic tissue. No significant flow is found on color Doppler imaging . Further investigation on CT or MRI is usually needed to delineate the full extent of the lesion, owing to its obscuration by the scapula (Figure B).…”

“…No significant flow is found on color Doppler imaging. [28][29][30][31][32][33] Further investigation on CT or MRI is usually needed to delineate the full extent of the lesion, owing to its obscuration by the scapula (Figure 22B).…”