Nuri DÜZGÜN, Yaşar ÜNLÜ, Mustafa ÇALIK, Hıdır ESME, Saniye GÖKNİL ÇALIK, Taha Tahir BEKÇİ

NADİR BİR GÖĞÜS AĞRISI NEDENİ ELASTOFİBROMA DORSİ

Elastofibroma dorsi periskapular bölgede bulunan ve nadir görülen psödotümöral bir lezyondur. Yaşlılarda %24 oranında görülür. Lezyonun patogenezi tam bilinmemekle birlikte, skapula ve göğüs duvarı arasında tekrarlayan mikrotravmaların fibroelastik dokuda reaktif hiperproliferasyon oluşturarak elastofibroma dorsiye neden olduğu düşünülmektedir. Elastofibroma dorsi, genelde 50 yaşın üzerindeki hastalarda görülmesi, periskapular bölgede ve derin yerleşimli olması nedeni ile çoğu zaman malign tümör sanılabilmektedir. Olğumuzda, metastatik akciğer karsinomu tanısı ile kliniğimize yattığı esnada yapılan muayenede bilateral subskapular bölgede hareketle ağrılı ve karakteristik "klik" sesinin alındığı lezyonlar tespit edildi. Operasyonda her iki kitleden de gönderilen frozen sonucu benign olarak bildirildi. Her iki kitle total olarak eksize edildi. Hasta postoperatif 14. gün taburcu edildi.

ELASTOFIBROMA DORSI: A RARE CAUSE OF CHEST PAIN

Elastofibroma dorsi is a rare pseudotumoral lesion located in the periscapular region. Prevalence is up to 24% in the elderly. The pathogenesis of the lesion is still unclear, but repetitive microtrauma by friction between the scapula and the thoracic wall may cause the reactive hyperproliferation of fibroelastic tissue. This lesion is usually seen in patients over the age of 50 years and is not uncommonly mistaken as a malignant tumour because of its size and location deep to the periscapular muscles. In our case, metastatic lung cancer examination in our clinic with bilateral subcapsular mass was found lying at the time. The frozen section report of the two masses was reported as benign in operation. The two mass was totally removed. At the 14th postoperative day, the patient was discharged.

PDF

___

Briccoli A, Casadei R, Di Renzo M, Favale L, Bacchini P, Bertoni F: Elastofibroma dorsi. Surg Today 2000, 30(2): 147-152.
Oueslati S, Douira-Khomsi W, Bouaziz MC, Zaouia K: Elastofibroma dorsi: A report on 6 cases. Acta Orthop Belg 2006; 72(2): 237-242.
O. H. Jarvi and A. E. Saxen, "Elastofibroma dorsi," Acta Pathologica et Microbiologica Scandinavica, vol. 144, supplement 52, pp. 83-84, 1961.
Kransdorf MJ, Meis JM, Montgomery E. Elastofibroma: MR and CT appearance with radiologic-pathologic correlation. AJR Am J Roentgenol 1992; 159: 575-9. [PubMed: 1503030].
Naylor MF, Nascimento AG, Sherrick AD, McLeod RA. Elastofibroma dorsi: Radiologic findings in 12 patients. AJR Am J Roentgenol 1996; 167: 683-7. [PubMed: 8751681].
Brandser EA, Goree JC, El-Khoury GY. Elastofibroma dorsi: prevalence in an elderly patient population as revealed by CT. AJR Am J Roentgenol 1998; 171: 977e80.
Bianchi S, Martinoli C, Abdelwahab IF, Gandolfo N, Derchi LE, Damiani S. Elastofibroma dorsi: sonographic findings. AJR Am J Roentgenol 1997; 169: 1113e5.
Nagamine N, Nohara Y, Ito E Elastofibroma in Okinawa. A clinical-pathological study of 170 cases. Cancer 1982; 50: 1794-95.
Hayes AJ, Alexander N, Clark MA, Thomas JM Elastofibroma: a rare soft tissue tumour with a pathognomonic anatomical location and clinical symptom. Eur J Surg Oncol 2004; 30: 450-453
Heck S, Thomas G, Mader K et al Bilateral elastofibroma as unusual cause of shoulder pain Plast Reconstr Surg 2003; 112: 1959-1961.
Majo J, Gracia I, Doncel A et al Guix M. Elastofibroma dorsi as a cause of shoulder pain or snapping scapula. Clin Orthop Relat Res 2001; 388: 200-204.
Stemmermann GN, Stout AP. Elastofibroma dorsi. Am J Clin Pathol 1962; 37: 499 506.
Battaglia M, Vanel D, Pollastri P, Balladelli A, Alberghini M, Staals EL, et al. Imaging patterns of elastofibroma dorsi. Eur J Radiol 2009; 72(1): 16-21.
Coşkun A, Yıldırım M. Bilateral Elastofibroma Dorsi. Ann Thorac Surg 2011; 92: 2222-4.
Domanski HA, Carlén B, Sloth M, Rydholm A. Elastofibroma dorsi has distinct cytomorphologic features, making diagnostic surgical biopsy unnecessary: cytomorphologic study with clinical, radiologic, and electron microscopic correlations. Diagn Cytopathol 2003; 29(6)7-33.
Turna A, Yilmaz M.A, Urer N et al Bilateral elastofibroma dorsi. Ann Thorac Surg 2002; 73: 630-632
Guha AR, Raja RC, Devadoss VG. Elastofibroma dorsi-a case report and review of literature. Int J Clin Pract 2004; 58: 218-20.
Charissoux JL, Mabit C, Fiorenza F, Gougam T, Leboutet MJ. Elastofibroma in the scapular region. A case report and review of the literature. Rev Chir Orthop Reparatrice Appar Mot 2000; 86: 98-103. [Abstract]
Muratori F, Esposito M, Rosa F, Liuzza F, Magarelli N, Rossi B, et al. Elastofibroma dorsi: 8 case reports and a literature review. J Orthop Traumatol 2008; 9(1):3-7.