Subclinical Elastofibromas in the Scapular Region in an Autopsy Series.

Abstract

In a series of 235 autopsies, changes in the subcapsular thoracic fascia similar to elastofibroma dorsi (Järvi & Saxén 1959, ‐et al. 1969) were found in 39 cases, all at least 58 years old. In people over 55 years, the frequency was 24.4 per cent in females and 11.2 per cent in males. In addition to hypertrophy and secondary degeneration of elastic fibres, necrosis of collagenous‐, adipose‐, muscular‐, and nervous tissue, as well as formation of clefts, cysts and bursae was found in 85 per cent of cases presenting elastic changes—both in connection with them and outside the degenerated areas—as well as in 39 per cent of cases where no elastic degeneration occurred. Other changes included extensive scarring of the tissue, followed by reduction of fat and, more seldom, oedema and inflammatory infiltration. Breaks in the elastic cage, necrosis and fibrosis of arterial walls were found in 44 per cent of cases of elastic degeneration and in 14 per cent of cases without degeneration. In veins, more extensive wall fibrosis occurred, leading to necrosis; in cases of elastic degeneration the adventitial elastic network was also involved. Venous changes were found in 90 per cent of the cases of elastic degeneration and in 30 per cent of cases without degeneration. Direct mechanical stress on elastic tissue may be an important cause of hypertrophy and secondary degeneration of elastic fibres, and also of diffuse increase of collagenous tissue. On the other hand, nutritional deficiency due to failing resistance of the vascular system against friction of the scapula and streching movements of the upper extremities may play a main part in necrotic tissue changes.

Elastofibromatous Changes and Hyperelastosis of the Oral Mucosa

“…the small bowel and the trachea of an 88-year-old female and a 67 year-old male, respectively who died from unrelated causes [8]. It is not clear whether elastofibromatous changes represent a reaction to trauma [9] or an initial, subclinical stage in the development of an elastofibroma, as it has been proposed for the elastofibromatous changes commonly seen in routine autopsy cases in the thoracic fascia under the lower portion of the scapula [10]. Interestingly, elastofibromatous changes have been found to occur in 2.6% out of 426 of all routine dorsal spine biopsies in a study by Daum et al [11] indicating the presence of a ''degenerative process practically unknown to contemporary medicine'' with specific characteristics and treatment.…”

Elastofifibroma Dorsi: An Uncommon Soft Tissue Tumor: Case Report

“…4 The rates of elastofibroma seen in the autopsy series were 11.2% in males and 24.4% in females older than 55 years. 5 The majority of the patients were housewives in the present series and 37.2% of the cases showed bilateral ED but only 19.6% of the cases underwent resection. The bilaterality rates was between 12-73% in the clinical series of the literature.…”

Elastofibroma dorsi: a case report

“…Literatürde, reaktif fibromatosis, elastik dejenerasyon, vasküler yetmezlik sonucu dejenerasyon gibi görüşler ileri sürülmüştür. [6,7] Elastofibroma dorsi sıklıkla ileri yaştaki kadınlarda ve sunulan olgudaki gibi daha çok tek taraflı görülür. [2] Elastofibroma dorsi saptanan hastaların büyük bir bölü-münde klinik semptom yoktur.…”