Elastofibroma dorsi--differential diagnosis in chest wall tumours.
BACKGROUND
Elastofibromas are benign soft tissue tumours mostly of the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle with a prevalence of up to 24% in the elderly. The pathogenesis of the lesion is still unclear, but repetitive microtrauma by friction between the scapula and the thoracic wall may cause the reactive hyperproliferation of fibroelastic tissue.


METHODS
We present a series of seven cases with elastofibroma dorsi with reference to clinical findings, further clinical course and functional results after resection, as well as recurrence. Data were obtained retrospectively by clinical examination, phone calls to the patients' general practitioners and charts review. Follow-up time ranged from four months to nine years and averaged 53 months.


RESULTS
The patients presented with swelling of the infrascapular region or snapping scapula. In three cases, the lesion was painful. The ratio men/women was 2/5 with a mean age of 64 years. The tumor sizes ranged from 3 to 13 cm. The typical macroscopic aspect was characterized as poorly defined fibroelastic soft tissue lesion with a white and yellow cut surface caused by intermingled remnants of fatty tissue. Microscopically, the lesions consisted of broad collagenous strands and densely packed enlarged and fragmented elastic fibres with mostly round shapes. In all patients but one, postoperative seroma (which had to be punctuated) occurred after resection; however, at follow-up time, no patient reported any decrease of function or sensation at the shoulder or the arm of the operated side. None of the patients experienced a relapse.


CONCLUSIONS
In differential diagnosis of soft tissue tumors located at this specific site, elastofibroma should be considered as likely diagnosis. Due to its benign behaviour, the tumor should be resected only in symptomatic patients.
Daigeler
Adrien
A
Department of Plastic Surgery, Burn Center, Hand Center, Sarcoma Reference Center, BG-Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. adrien.daigeler@rub.de
Vogt
Peter Maria
PM
Busch
Kay
K
Pennekamp
Werner
W
Weyhe
Dirk
D
Lehnhardt
Marcus
M
Steinstraesser
Lars
L
Steinau
Hans-Ulrich
HU
Kuhnen
Cornelius
C
D000368:Aged; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005260:Female; D005350:Fibroma / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012983:Soft Tissue Neoplasms / Q000473:pathology* / Q000601:surgery; D013899:Thoracic Neoplasms / Q000473:pathology* / Q000601:surgery; D035441:Thoracic Wall / Q000473:pathology*; D016896:Treatment Outcome