Lococo F, Cesario A, Mattei F, Petrone G, Vita L M, Petracca-Ciavarella L, Margaritora S, Granone P
Department of General Thoracic Surgery, Catholic University, Rome, Italy.
Thorac Cardiovasc Surg. 2013 Apr;61(3):215-22. doi: 10.1055/s-0032-1328932. Epub 2013 Jan 23.
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.
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.
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.
ELD is relatively uncommon, benign, and well controlled by radical surgery.
背部弹力纤维瘤（ELD）是一种罕见的胸壁软组织良性肿瘤。到目前为止，英文文献中仅报道了少数大型系列研究，据我们所知，放射学评估和临床管理仍未达成共识。本研究的目的是基于单一机构的、同质且丰富的经验，提供充分证据以支持病因学和“临床实用性分级”分类假设。
我们报告了71例ELD病例的观察信息，并在此基础上讨论临床发病特征、放射学和手术特征以及病理和免疫组化证据。
在1994年1月至2009年9月期间，我们机构对71例连续诊断为ELD的患者（23例男性和48例女性；平均年龄：60.2岁；标准差[SD]±8.3岁）进行了手术治疗。ELD位于右侧的有34例患者（47.9%），左侧的有25例（35.2%），双侧的有12例（16.9%）。9例患者的ELD为同步诊断，3例为异时诊断。38例患者（53.5%）无明显症状；33例（46.5%）报告在肩部运动时有咯嗒感或局部肩胛肿胀。66例（93%）患者接受了根治性手术切除，5例患者仅进行了活检。平均住院时间为3.0天（SD±1.2天），发病率为10.6%（1例术后大出血需要进行止血手术修正）。单因素分析显示，发病率的发生概率随肿瘤大小增加。所有接受手术的患者在随访时均存活且状况良好，无复发迹象，症状完全缓解。
ELD相对不常见，为良性，可通过根治性手术得到良好控制。
