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一位 78 岁男性,因左肩胛下区肿块就诊,影像学表现为弹性纤维瘤。

A 78-Year-Old Man with Elastofibroma Dorsi Presenting as a Left Subscapular Mass.

机构信息

Department of Surgery, European Interbalkan Medical Center, Pylaia, Thessaloniki, Greece.

3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Am J Case Rep. 2024 Nov 23;25:e945013. doi: 10.12659/AJCR.945013.

Abstract

BACKGROUND Elastofibroma dorsi is a rare, benign soft-tissue tumor, emerging in the subscapular area and exhibiting higher prevalence in elderly women. Despite its slow growth rate and asymptomatic nature in most patients, elastofibroma can cause swelling, pain, and discomfort during shoulder movements. Imaging and histopathologic data combined with a detailed history are essential to exclude malignancies and provide suitable treatment. CASE REPORT This report describes the case of a 78-year-old man with an incidental finding of elastofibroma dorsi, presenting as an asymptomatic left subscapular mass. Physical examination revealed the mass, the presence of which was later confirmed through an MRI scan. The tumor was surgically excised without any postoperative complications. Histopathologic findings from a biopsy supported the diagnosis of elastofibroma dorsi, showing an abundance of thick and irregular elastic fibers, giving a "rope-like" appearance in hematoxylin and eosin stain. Additionally, Verhoeff-Van Gieson stain highlighted the elastic fibers, making their characteristic arrangement and appearance evident. The patient was then discharged from our hospital and made a complete recovery. CONCLUSIONS Despite its benign nature and rarity, elastofibroma dorsi should be included in the differential diagnosis of subscapular masses. Proper imaging and histopathological examination are crucial for a definitive diagnosis, to ensure that patients receive the appropriate and necessary treatment and guidance. Furthermore, additional research is needed to completely clarify the pathophysiologic mechanism responsible for the development of elastofibroma dorsi.

摘要

背景

背阔肌纤维瘤是一种罕见的良性软组织肿瘤,通常发生于肩胛下区域,多见于老年女性。尽管大多数患者的肿瘤生长缓慢且无症状,但它仍可导致肩部运动时出现肿胀、疼痛和不适。影像学和组织病理学数据结合详细的病史对于排除恶性肿瘤并提供合适的治疗至关重要。

病例报告

本报告描述了一位 78 岁男性的病例,他因偶然发现背阔肌纤维瘤而就诊,表现为左侧肩胛下区无症状肿块。体格检查发现了该肿块,随后通过 MRI 扫描进一步证实。肿瘤通过手术切除,术后无并发症。活检的组织病理学结果支持背阔肌纤维瘤的诊断,苏木精和伊红染色显示大量厚而不规则的弹性纤维,呈现“绳索样”外观。此外,Verhoeff-Van Gieson 染色突出了弹性纤维,使其特征性排列和外观明显可见。患者随后出院,完全康复。

结论

尽管背阔肌纤维瘤为良性且罕见,但仍应将其纳入肩胛下肿块的鉴别诊断中。适当的影像学和组织病理学检查对于明确诊断至关重要,以确保患者获得适当和必要的治疗和指导。此外,还需要进一步研究以完全阐明背阔肌纤维瘤发展的病理生理机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1216/11591370/369044233750/amjcaserep-25-e945013-g001.jpg

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