gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

A surprisingly common tumor of the thoracic wall: Elastofibroma dorsi

Meeting Abstract

  • corresponding author presenting/speaker Adrien Daigeler - Universitätsklinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, operatives Referenzzentrum für Gliedmaßentumoren, Bochum, Deutschland
  • Kai Busch - Universitätsklinik für Plastische, Hand- und Wiederherstellungschirurgie, Verbrennungszentrum, Hannover
  • Peter-Maria Vogt - Universitätsklinik für Plastische, Hand- und Wiederherstellungschirurgie, Verbrennungszentrum, Hannover
  • Marcus Lehnhardt - Universitätsklinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, operatives Referenzzentrum für Gliedmaßentumoren, Bochum
  • Lars Steinsträßer - Universitätsklinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, operatives Referenzzentrum für Gliedmaßentumoren, Bochum
  • Cornelius Kuhnen - Institut für Pathologie der Ruhr-Universität, Bochum
  • Hans-Ulrich Steinau - Universitätsklinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, operatives Referenzzentrum für Gliedmaßentumoren, Bochum

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPE637

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dkk2006/06dkk743.shtml

Veröffentlicht: 20. März 2006

© 2006 Daigeler et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Elastofibromas are benign soft tissue tumors mostly of the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle with a prevalence of 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.

Materials and Methods: We followed up 7 (5 male, 2 female) patients with infrascapular elastofibroma dorsi. The age at time of treatment averaged 64 years (46-79); mean follow up time was 53 months (4 months to 9 years). Data was obtained from patients records, phone calls to the patients general practitioners, clinical follow up examination, and Computed Tomography of the chest.

Results: All tumors were located at the same region between the thoracic wall, the anterior serratus and the latissimus dorsi muscle. Tumor size ranged from 3 to 13 cm. In three patients the tumor was located at the side of the dominant hand, in one patient we found bilateral elastofibroma. None of the patients reported excessive activity involving the arms or shoulders during lifetime. The patients presented with swelling of the infrascapular region or snapping scapula. In three cases the lesion was painful. In all patients but one postoperative seroma, which had to be punctuated occurred, but at follow up time no patient reported any decrease of function or sensation at the shoulder or the arm of the operated side.

Conclusions: With the tumors equally occurring at the dominant and nondominant hand a corellation to mechanic stress could not be comprehended. The may be a result of insufficient immobilisation, but taking the usually high age of the patients into account, immobilisation bears the risk of long lasting stiffness in the shoulder girdle, whereas punctuation of a seroma may prolong reconvalescence but retrospectively was not experienced as relevant discomfort by our patients. In differential diagnosis of soft tissue tumors located at this specific site elastofibroma should be considered as likely diagnosis. Only symptomatic patients should be resected. Open biopsy should be performed to exclude malignancy and to reassure the asymptomatic patient and to avoid unnecessary wide and radical resection in symptomatic patients.