Etiological hypothesis on five cases of elastofibroma dorsi
Elastofibroma dorsi is a rare benign lesion of the soft tissue of the thoracic wall, usually located in the subscapular region. It occurs mostly in elderly women patients. This lesion usually arises in right region but it can also be bilateral. Even if the pathogenesis is still unknown, it is considered that "rubbing" of the scapula against the thorax wall could determine growth of the elastofibroma. The differential diagnosis from sarcoma is required but the typical localization and the MRI suggest the diagnosis which should be confirm with the histological exam. The Authors present their experience on five patients, with a median age of 64, affected by elastofibroma dorsi. In two cases, a builder and an obstetrician, the lesion was bilateral; in the other three cases, two teachers and a notary, the lesion are right-sided. A thorax computed tomography (CT) revealed a lesion with heterogeneous density, and the magnetic resonance imaging (MRI) , shows intralesional areas of medium and high intensity signals in the tissue with low intensity in both T12 and T2-sequences. The patient underwent surgery and diagnosis was confirmed by the histological exam. Prevalence of the right localization reported in literature, the correlation between the job of the patients and the lesion localization, more evident in the women, confirmed, according to the other Authors, the etiological hypothesis which considers the lesion as a proliferative response of the connective tissue to the repeated mechanical stress which excessive elastic fibrollogenesis probably due to genetic predisposition.
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