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NADİR GÖRÜLEN ELASTOFİBROMA DORSİ’DE KLİNİK DENEYİMİMİZE DAYANARAK TANI VE TEDAVİ ALGORİTMASI OLUŞTURULMASI

Amaç: Bu çalışmamızdaki amacımız Elastofibroma Dorsi tanısı ile opere edilen hastaların verilerini literatüreşliğinde retrospektif olarak inceleyerek elde edilen klinik sonuçları sunmaktır. Ayrıca Elastofibroma Dorsi içintanı ve tedavi algoritması önermektir.Materyal ve Metod: Bu çalışmada kliniğimizde Ocak 2010- Ağustos 2017 yılları arasında patoloji raporları ileelastofibrom tanısı alan 31 hasta (toplamda 39 vaka) geriye dönük olarak incelendi. Hastaların cinsiyetleri,yaşları, şikâyetleri, tümörün lokalizasyonu, hastanın dominant ekstremitesi, ailesel yatkınlık hikâyesi olup ol-madığı, tanı için uygulanan işlemler ve karşılaşılan komplikasyonlar değerlendirildi.Bulgular: Hastaların ortalama yaşları 60,8±5,5 olarak saptandı. Kadın erkek oranı 26/5’dir. Yirmi beş (%80,6)hasta semptomatikti. Altı (%19,4)hasta ise başka bir nedenle torakotomi yapılırken tanı aldı ED tanısı alan 5erkek hastanın 4 tanesinin aktif şikâyeti olmadığı tespit edildi.Sekiz (%25,8) hastanın kitlesinin bilateral olduğu tespit edildi. Bilateral kitlesi olanların ailesel yatkınlık oranıistatiksel olarak anlamlı değildi. (p=0,96) Yirmidört hastanın sağ ekremitesinin yedi hastanın sol ekstremite-sinin dominant olduğu tespit edildi. Dominant ekstremite ile tümör lokalizasyonlarının istatiksel testlerindeanlamlı sonuç elde edilmedi. Hastaların anamnezinde birinci derece akrabalarında benzer rahatsızlık tarif-leyen sadece 4 hasta mevcuttu. Bu hastaların verileri ile yapılan istatiksel analiz sonucu anlamlı bir sonucaulaşılamadı.Sonuç: Tanı için ayrıntılı anamnez ve fizik muayeneye ilaveten yapılacak olan radyolojik tetkikler ile Elasto-fibroma Dorsi (ED) tanısı konulması güvenilir şekilde yapılabilir. Ek girişimsel işlemler sadece ElastofibromaDorsi (ED) tanısının konulamadığı hastalara yapılmalıdır. Tedavi için semptomatik hastalarda tümörün totalolarak çıkartılması yeterlidir. Asemptomatik hastalarda cerrahi yapmak, düşükte olsa var olan akut ve kronikkomplikasyon riski nedeniyle gereksizdir.

Establishing Diagnosis and Treatment Algorithm Based on Clinical Experience for Rare Tumor Elastofibroma Dorsi

Aim: The object of this study is to analyze the data of the patients who had been operated due to the diagnosis of elastofibroma dorsi, with literature retrospectively and presenting the clinical results. Also proposing a diagnosis and treatment algorithm for elastofibroma dorsi. Material and Method: In our study 31 patients (39 cases in total) diagnosed with elastofibroma dorsi by pathology reports in our clinic between January 2010 – August 2017 were examined retrospectively. The gender, age, complaints of the patients, localization of the tumor, dominant extremity of the patient, having a familial diathesis, operations conducted for the diagnosis and the complications encountered were assessed. Results: The average age of the patients is determined as 60.8±5.5. The female/male ratio is 26/5. Twenty- five (80.6%) patients are symptomatic. Six (19.4%) patients were diagnosed while conducting thoracotomy, 4 out of 5 male patients who got diagnosed with elastofibroma dorsi were determined not to have active complaints. It was determined that eight (25.8%) patients have a bilateral bulk. Familial diathesis ratio of the patients with bilateral bulk was not significant. (p=0.96) Right extremity of twenty-four patients and left extremity of seven patients were determined as dominant. A significant result could not be obtained in the statistical tests of dominant extremity and tumor localization. During the anamnesis of the patient only 4 of them described a similar disease among their first-degree relatives. The results of statistical analysis performed with the data of these patients could not be significant. Conclusion: By radiological examinations in addition to detailed anamnesis and physical examination, elastofibroma dorsi can be diagnosed confidently. Extra interventional operations should be conducted for the patients who cannot be diagnosed with elastofibroma dorsi. To treat the symptomatic patients removing the tumor totally is sufficient. Performing a surgical operation to the asymptomatic patients is unnecessary due to the acute and chronic complication risk even at low levels

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