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Thorac Cardiovasc Surg 2013; 61(03): 215-222
DOI: 10.1055/s-0032-1328932
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Elastofibroma Dorsi: Clinicopathological Analysis of 71 Cases

F. Lococo
1   Department of General Thoracic Surgery, Catholic University, Rome, Italy
,
A. Cesario
1   Department of General Thoracic Surgery, Catholic University, Rome, Italy
2   Deputy Scientific Director, IRCCS San Raffaele Pisana, Rome, Italy
,
F. Mattei
2   Deputy Scientific Director, IRCCS San Raffaele Pisana, Rome, Italy
,
G. Petrone
3   Department of Pathology, Catholic University of Rome, Rome, Italy
,
L. M. Vita
1   Department of General Thoracic Surgery, Catholic University, Rome, Italy
,
L. Petracca-Ciavarella
1   Department of General Thoracic Surgery, Catholic University, Rome, Italy
,
S. Margaritora
1   Department of General Thoracic Surgery, Catholic University, Rome, Italy
4   Thoracic Surgery Unit, Centro Oncologico Fiorentino, Florence, Italy
,
P. Granone
1   Department of General Thoracic Surgery, Catholic University, Rome, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

29. Mai 2012

11. Juli 2012

Publikationsdatum:
23. Januar 2013 (online)

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Abstract

Introduction Elastofibroma dorsi (ELD) is a rare soft tissue benign tumor of the chest wall. So far, only a few large series have been reported in the English literature and, to the best of our knowledge, radiological assessment and clinical management remain without consensus. The aim of this study is to provide, on the basis of a single-institutional, homogeneous and large experience, ample evidences to support etiological and “clinical-usefulness-grade” classification hypotheses.

Materials and Methods We report observational information on 71 ELD cases and, on the basis of these, we discuss the clinical onset features, radiological and surgical characteristics, as well as pathological and immunohistochemical evidences.

Results In the period between January 1994 and September 2009, 71 consecutive patients (23 male and 48 female; mean age: 60.2 years; standard deviation [SD] ± 8.3 years) with ELD diagnosis were surgically treated at our institution. ELD was right sided in 34 patients (47.9%), left in 25 (35.2%), and bilateral in 12 (16.9%). In nine patients, ELD were diagnosed synchronously and three metachronously. Thirty-eight patients (53.5%) had no significant symptoms; 33 (46.5%) reported a clunking sensation or a localized scapular swelling during the shoulder movements. Sixty-six (93%) patients underwent surgical excision with radical intent while in five patients, a biopsy-only procedure was undertaken. Mean hospital stay was 3.0 days (SD ± 1.2 days) with a morbidity of 10.6% (one case of major postoperative bleeding requested a surgical revision of the hemostasis). At the univariate analysis, the probability of occurrence of morbidity increases with tumor size. All operated patients are alive and well at follow-up with no sign of recurrence and complete resolution of the symptomatology.

Conclusions ELD is relatively uncommon, benign, and well controlled by radical surgery.

Keywords

elastofibroma dorsi - soft tissue tumors - chest wall tumors - elastin
 

  • References

  • 1 Jarvi O, Saxen E. Elastofibroma dorse. Acta Pathol Microbiol Scand Suppl 1961; 51 (Suppl 144): 83-84
    PubMedGoogle Scholar
  • 2 Battaglia M, Vanel D, Pollastri P , et al. Imaging patterns in elastofibroma dorsi. Eur J Radiol 2009; 72 (1) 16-21
    CrossrefPubMedGoogle Scholar
  • 3 Pierce III JC, Henderson R. Hypermetabolism of elastofibroma dorsi on PET-CT. AJR Am J Roentgenol 2004; 183 (1) 35-37
    CrossrefPubMedGoogle Scholar
  • 4 Järvi OH, Länsimies PH. Subclinical elastofibromas in the scapular region in an autopsy series. Acta Pathol Microbiol Scand [A] 1975; 83 (1) 87-108
    PubMedGoogle Scholar
  • 5 Daigeler A, Vogt PM, Busch K , et al. Elastofibroma dorsi—differential diagnosis in chest wall tumors. World J Surg Oncol 2007; 5: 15
    CrossrefPubMedGoogle Scholar
  • 6 Muramatsu K, Ihara K, Hashimoto T, Seto S, Taguchi T. Elastofibroma dorsi: diagnosis and treatment. J Shoulder Elbow Surg 2007; 16 (5) 591-595
    CrossrefPubMedGoogle Scholar
  • 7 McComb EN, Feely MG, Neff JR, Johansson SL, Nelson M, Bridge JA. Cytogenetic instability, predominantly involving chromosome 1, is characteristic of elastofibroma. Cancer Genet Cytogenet 2001; 126 (1) 68-72
    CrossrefPubMedGoogle Scholar
  • 8 Nagamine N, Nohara Y, Ito E. Elastofibroma in Okinawa. A clinicopathologic study of 170 cases. Cancer 1982; 50 (9) 1794-1805
    CrossrefPubMedGoogle Scholar
  • 9 Nishio J, Isayama T, Iwasaki H, Naito M. Elastofibroma dorsi: diagnostic and therapeutic algorithm. J Shoulder Elbow Surg 2012; 21 (1) 77-81
    CrossrefPubMedGoogle Scholar
  • 10 Hernández JL, Rodríguez-Parets JO, Valero JM , et al. High-resolution genome-wide analysis of chromosomal alterations in elastofibroma. Virchows Arch 2010; 456 (6) 681-687
    CrossrefPubMedGoogle Scholar
  • 11 Stemmermann GN, Stout AP. Elastofibroma dorsi. Am J Clin Pathol 1962; 37: 499-506
    PubMedGoogle Scholar
  • 12 Chandrasekar CR, Grimer RJ, Carter SR , et al. Elastofibroma dorsi: an uncommon benign pseudotumour. Sarcoma 2008; 2008: 756565
    PubMedGoogle Scholar
  • 13 Freixinet J, Rodríguez P, Hussein M, Sanromán B, Herrero J, Gil R. Elastofibroma of the thoracic wall. Interact Cardiovasc Thorac Surg 2008; 7 (4) 626-628
    CrossrefPubMedGoogle Scholar
  • 14 Coskun A, Yildirim M. Bilateral elastofibroma dorsi. Ann Thorac Surg 2011; 92 (6) 2242-2244
    CrossrefPubMedGoogle Scholar
  • 15 Turna A, Yilmaz MA, Urer N, Bedirhan MA, Gürses A. Bilateral elastofibroma dorsi. Ann Thorac Surg 2002; 73 (2) 630-632
    CrossrefPubMedGoogle Scholar
  • 16 Machens HG, Mechtersheimer R, Göhring U, Schlag PN. Bilateral elastofibroma dorsi. Ann Thorac Surg 1992; 54 (4) 774-776
    CrossrefPubMedGoogle Scholar
  • 17 Ochsner JE, Sewall SA, Brooks GN, Agni R. Best cases from the AFIP: elastofibroma dorsi. Radiographics 2006; 26 (6) 1873-1876
    CrossrefPubMedGoogle Scholar
  • 18 Yu JS, Weis LD, Vaughan LM, Resnick D. MRI of elastofibroma dorsi. J Comput Assist Tomogr 1995; 19 (4) 601-603
    CrossrefPubMedGoogle Scholar
  • 19 Nishida A, Uetani M, Okimoto T, Hayashi K, Hirano T. Bilateral elastofibroma of the thighs with concomitant subscapular lesions. Skeletal Radiol 2003; 32 (2) 116-118
    CrossrefPubMedGoogle Scholar
  • 20 Mortman KD, Hochheiser GM, Giblin EM, Manon-Matos Y, Frankel KM. Elastofibroma dorsi: clinicopathologic review of 6 cases. Ann Thorac Surg 2007; 83 (5) 1894-1897
    CrossrefPubMedGoogle Scholar