Is it necessary to always resect elastofibroma dorsi?

Abstract

Background: Elastofibroma dorsi (ED) is a benign soft tissue tumour of the subscapular region of the chest wall. It is a frequent lesion, especially seen in females and in the elderly. It remains unclear whether the size or symptomatology of the tumour is important to make a resection decision. Our aim in this study is to reveal the results between asymptomatic or symptomatic ED cases, and to reveal which factors are important for making a resection decision. Methods: Patients operated between January 2010 and December 2019 were included in the study, and divided into two groups as patients who were asymptomatic or with various symptoms. Patients were evaluated in terms of demographic and operational factors. Results: The study included 57 patients with the average age of 56.1 AE 11.5 years. Whilst 31 (54.4%) of these patients were asymptomatic, 26 (45.6%) were symptomatic. There was a statistical significance between groups in terms of occupation (P < 0.001), comorbidity (P = 0.042) and the duration of complaints (P = 0.001). A statistically significant difference was analysed between comorbidity versus early and late complications (P = 0.011 and P = 0.002, respectively). Conclusion: ED probably occurs as a result of repeated trauma in the subcapular region in people who use their arms extensively. Regardless of the size of the lesion, surgery should be avoided as much as possible, especially in asymptomatic patients. However, in patients who are symptomatic, a precise surgical procedure can give satisfactory results. In these patients, who are generally elderly, early and late complications can be seen more, if they have comorbidity.

Marjinal rezeksiyon sonrası gelişen tek merkezli 31 elastofibroma dorsi vakalarında komplikasyonları etkileyen faktörler

“…ED is an uncommon, benign, poorly circumscribed connective-tissue tumor classically located in the subscapular region (5,8). Although ED is mostly unilateral and usually located on the right side, some studies reported bilateral involvement in 10% to 50% of cases (2,4,5,11,12). The rates of right-sidedness (45.2%), left-sidedness (25.8%), and bilaterality (29.0%) in our study are consistent with the literature.…”

“…The rates of right-sidedness (45.2%), left-sidedness (25.8%), and bilaterality (29.0%) in our study are consistent with the literature. In addition, it has been reported that large lesions are more common in women and the elderly (3,5,11). In our study, which had a female/male ratio of 24/7, no significant relationship was found between the size of the masses and gender or age.…”

“…Limitations of shoulder abduction and feelings of stiffness were particularly observed in symptomatic patients in previous reports (5,6), consistent with our study, and these symptoms improved after surgery. While some researchers reported a relationship between the dimensions of the ED and the severity and presence of symptoms (12), other findings have suggested no such relationships (11). Our study revealed a positive and significant correlation between tumor size and variables including weight, BMI, postoperative VAS score, and complications.…”

“…As in our cases, no metastasis or malignant transformation has been reported in the literature despite the proximity of ED to the thorax and its high vascularity (7). The differential diagnosis should consider benign tumors such as fibrolipoma and neurofibroma, aggressive tumors such as desmoid fibromatosis, and sarcomas (7,11,12). Due to the variety of clinical manifestations, ED may be misdiagnosed as rotator cuff tear, subacromial bursitis, cervical pathologies, or chronic back pain.…”

Unusual Late Complication of Latissimus Dorsi Free Flap Donor Site: Elastofibroma Dorsi

“… 3 Surgical removal of the lesion is the recommended treatment, especially in symptomatic cases. Although in a recent study of 57 ED patients, Sahin et al discourage routine removal of ED regardless of its size, 9 considering there have been no cases of malignant proliferation following ED described in the literature. As our patient complained of pain, snapping, and range of motion restriction, we proceeded with the surgical treatment.…”