Elastofibroma

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Classification according to ICD-10
D21 Other benign neoplasms of connective and other soft tissues
ICD-10 online (WHO version 2019)
Computed tomography of an elastofibroma dorsi on both sides, largely symmetrically below the serratus anterior muscle. In addition to fuzzy, soft tissue-dense parts, you can also see fatty parts. The location is classic.

An elastofibroma is a tumor-like , poorly demarcated but benign tissue proliferation consisting of increased and irregular elastic fibers . In the vast majority of cases, the elastofibroma is found under or anatomically ventral to the shoulder blade, mostly under the serratus anterior muscle and here reaching up to the ribs. This is why the term Elastofibroma dorsi (from Latin dorsi "of the back") is well established. Occurrence in other parts of the body such as the neck or thigh is reported to be very rare.

Initial description

The first description and thus the name was given in 1961 by O. Jarvi and E. Saxen.

Incidence and distribution

The elastofibroma usually occurs in people from the 5th decade of life. Individual cases in children are described. There are different statements about the distribution between the sexes. While some sources indicate a significantly more frequent occurrence in women, others do not explicitly confirm this. The overall frequency has mostly and is sometimes still described as rare or very rare. On the other hand, several autopsy studies indicate significantly higher frequencies up to the high double-digit percentage range. A study from 1998, in which the frequency was determined by means of computed tomography, came to 2 percent in older patients. The elastofibroma dorsi can occur on one side, but often also on both sides. The occurrence in three places is described as an individual case.

Emergence

There is no clarity regarding the formation of an elastofibroma. In addition to other (e.g. genetic) causes, repeated microtraumas in particular are discussed.

Symptoms

In many cases, an elastofibroma dorsi is discovered by chance in computed tomography or magnetic resonance tomography without causing any symptoms. When symptoms occur, they are described unspecifically, sometimes with a snap at the shoulder blade or with pain.

Elastofibroma in histological section: hematoxylin-eosin staining
Elastofibroma in elastic staining

diagnosis

The depiction of the indistinctly delimited tissue proliferation at the above-mentioned point is possible both in computed tomography and in magnetic resonance tomography with typical features, so that the diagnosis can often be made with these imaging methods, especially if there is a finding on both sides. In individual cases, it is also possible to dispense with a tissue sample for security purposes. Especially with bilateral symmetrical findings, the appearance can also be misinterpreted or overlooked as a normal, anatomical structure.

Differential diagnosis

Other soft tissue tumors such as B. lipomas , fibromas or sarcomas are particularly suitable for differential diagnosis if the localization is not the typical one on the shoulder blade described above.

histology

The tissue examination reveals not only elastic and collagenous fibers but also mature adipose tissue.

therapy

Surgical removal of an elastofibroma is only recommended in cases with symptoms because of its benign nature.

Web links

Commons : Elastofibroma dorsi  - collection of images, videos and audio files

Individual evidence

  1. ↑ a b Jürgen Freyschmidt: Skeletal Diseases: Clinical-Radiological Diagnosis and Differential Diagnosis , Springer Verlag 2016, ISBN 9783662481363
  2. ↑ O. JARVI, E. SAXEN: Elastofibroma dorse. In: Acta pathologica et microbiologica Scandinavica. Supplement. Volume 51 (Suppl 144), 1961, pp. 83-84, PMID 13789598 .
  3. ^ Robert K. Brown, Kevin P. Clearkin, Kijin Nakachi, Claude O. Burdick: Elastofibroma Dorsi. In: New England Journal of Medicine. 275, 1966, p. 154, doi : 10.1056 / NEJM196607212750307 .
  4. ↑ ML Marin, KH Perzin, AM Markowitz: Elastofibroma dorsi: benign chest wall tumor. In: The Journal of thoracic and cardiovascular surgery. Volume 98, Number 2, August 1989, pp. 234-238, PMID 2755156 .
  5. ↑ a b c d e f P. H. Go, MC Meadows, EM Deleon, RS Chamberlain: Elastofibroma dorsi: A soft tissue masquerade. In: International journal of shoulder surgery. Volume 4, number 4, October 2010, pp. 97-101, doi : 10.4103 / 0973-6042.79797 , PMID 21655005 , PMC 3100815 (free full text).
  6. ↑ a b c A. Daigeler, PM Vogt, K. Busch, W. Pennekamp, ​​D. Weyhe, M. Lehnhardt, L. Steinstraesser, HU Steinau, C. Kuhnen: Elastofibroma dorsi - differential diagnosis in chest wall tumors. In: World journal of surgical oncology. Volume 5, 2007, p. 15, doi : 10.1186 / 1477-7819-5-15 , PMID 17280612 , PMC 1797045 (free full text).
  7. ^ EA Brandser, JC Goree, GY El-Khoury: Elastofibroma dorsi: prevalence in an elderly patient population as revealed by CT. In: American Journal of Roentgenology . Volume 171, Number 4, October 1998, pp. 977-980, doi : 10.2214 / ajr.171.4.9762978 , PMID 9762978 .
  8. Jump up ↑ JB Hassouna, B. Mezghani, B. Laamouri, L. Naija, I. Abbes, M. Slimane, TB Dhieb, K. Rahal: Triple locations of elastofibroma dorsi: First case report and review. In: Journal of orthopedics. Volume 12, Suppl 1October 2015, pp. S133 – S136, doi : 10.1016 / j.jor.2014.06.013 , PMID 26719607 , PMC 4674491 (free full text).
  9. ↑ a b c d I. S. Sarici, E. Basbay, M. Mustu, B. Eskut, F. Kala, O. Agcaoglu, M. Akici, E. Ozkurt: Bilateral elastofibroma dorsi: A case report. In: International journal of surgery case reports. Volume 5, number 12, 2014, pp. 1139–1141, doi : 10.1016 / j.ijscr.2014.10.032 , PMID 25437657 , PMC 4275815 (free full text).
  10. ↑ S. Nagano, M. Yokouchi, T. Setoyama, H. Sasaki, H. Shimada, I. Kawamura, Y. Ishidou, T. Setoguchi, S. Komiya: Elastofibroma dorsi: Surgical indications and complications of a rare soft tissue tumor . In: Molecular and clinical oncology. Volume 2, number 3, May 2014, pp. 421-424, doi : 10.3892 / mco.2014.257 , PMID 24772311 , PMC 3999122 (free full text).