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Surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases

BACKGROUND: Elastofibroma dorsi (ED) is a benign soft-tissue tumor of the chest wall located near the tip of the scapula. Clinical presentation includes swelling, pain and impairment of shoulder movements. The present literature relies only on few small case series. The aim of this study was to anal...

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Autores principales: Scamporlino, Adriana, Ruggiero, Ciro, Aramini, Beatrice, Morandi, Uliano, Stefani, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330361/
https://www.ncbi.nlm.nih.gov/pubmed/32642092
http://dx.doi.org/10.21037/jtd-20-649
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author Scamporlino, Adriana
Ruggiero, Ciro
Aramini, Beatrice
Morandi, Uliano
Stefani, Alessandro
author_facet Scamporlino, Adriana
Ruggiero, Ciro
Aramini, Beatrice
Morandi, Uliano
Stefani, Alessandro
author_sort Scamporlino, Adriana
collection PubMed
description BACKGROUND: Elastofibroma dorsi (ED) is a benign soft-tissue tumor of the chest wall located near the tip of the scapula. Clinical presentation includes swelling, pain and impairment of shoulder movements. The present literature relies only on few small case series. The aim of this study was to analyze the surgical management of ED, focusing on the debated topics regarding preoperative evaluation, operative technique, post-operative outcome and follow-up. METHODS: We conducted a single-center retrospective cohort analysis of patients operated for ED between 2003 and 2018. Diagnostic techniques were ultrasonography (US), computed tomography (CT-scan) and magnetic resonance imaging (MRI). CT-scan represented our preferred imaging study for preoperative assessment. Surgery was proposed for symptomatic and/or large lesions. Marginal excision through a muscle-sparing approach was performed. An open-door follow-up policy was adopted. All clinical, radiological, perioperative and pathological variables were matched in a univariate analysis. A multivariate analysis was performed to investigate risk factors for postoperative complications. Correlations analysis between radiological and pathological measurements of elastofibroma was conducted. RESULTS: Seventy elastofibromas were excised in 59 patients. Mean age was 59 years and female prevalence was 59%. All elastofibromas were completely resected with no recurrence. Postoperative complications rate was 17%. Complications were mild in most cases. At the univariate analysis, patients with body mass index (BMI) >25 had a longer operative time (P=0.048), patients on antiplatelet medications experienced a prolonged drainage time (P=0.006) and a higher rate of complications (P=0.038); the occurrence of complications resulted in prolonged drainage time (P=0.047) and length of stay (P=0.023). A BMI ≤25 was the only independent risk factor for postoperative morbidity (OR 8.71, P=0.024). CT-scan showed the highest correlation with pathological size (r=0.819), US the lowest (r=0.421). CONCLUSIONS: Marginal resection through a muscle-sparing approach is safe and effective for the treatment of ED. CT-scan can be adequate for preoperative assessment. Giving the benign nature of the lesion and the absence of recurrence after complete resection, an open-door follow-up may be appropriate.
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spelling pubmed-73303612020-07-07 Surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases Scamporlino, Adriana Ruggiero, Ciro Aramini, Beatrice Morandi, Uliano Stefani, Alessandro J Thorac Dis Original Article BACKGROUND: Elastofibroma dorsi (ED) is a benign soft-tissue tumor of the chest wall located near the tip of the scapula. Clinical presentation includes swelling, pain and impairment of shoulder movements. The present literature relies only on few small case series. The aim of this study was to analyze the surgical management of ED, focusing on the debated topics regarding preoperative evaluation, operative technique, post-operative outcome and follow-up. METHODS: We conducted a single-center retrospective cohort analysis of patients operated for ED between 2003 and 2018. Diagnostic techniques were ultrasonography (US), computed tomography (CT-scan) and magnetic resonance imaging (MRI). CT-scan represented our preferred imaging study for preoperative assessment. Surgery was proposed for symptomatic and/or large lesions. Marginal excision through a muscle-sparing approach was performed. An open-door follow-up policy was adopted. All clinical, radiological, perioperative and pathological variables were matched in a univariate analysis. A multivariate analysis was performed to investigate risk factors for postoperative complications. Correlations analysis between radiological and pathological measurements of elastofibroma was conducted. RESULTS: Seventy elastofibromas were excised in 59 patients. Mean age was 59 years and female prevalence was 59%. All elastofibromas were completely resected with no recurrence. Postoperative complications rate was 17%. Complications were mild in most cases. At the univariate analysis, patients with body mass index (BMI) >25 had a longer operative time (P=0.048), patients on antiplatelet medications experienced a prolonged drainage time (P=0.006) and a higher rate of complications (P=0.038); the occurrence of complications resulted in prolonged drainage time (P=0.047) and length of stay (P=0.023). A BMI ≤25 was the only independent risk factor for postoperative morbidity (OR 8.71, P=0.024). CT-scan showed the highest correlation with pathological size (r=0.819), US the lowest (r=0.421). CONCLUSIONS: Marginal resection through a muscle-sparing approach is safe and effective for the treatment of ED. CT-scan can be adequate for preoperative assessment. Giving the benign nature of the lesion and the absence of recurrence after complete resection, an open-door follow-up may be appropriate. AME Publishing Company 2020-05 /pmc/articles/PMC7330361/ /pubmed/32642092 http://dx.doi.org/10.21037/jtd-20-649 Text en 2020 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Scamporlino, Adriana
Ruggiero, Ciro
Aramini, Beatrice
Morandi, Uliano
Stefani, Alessandro
Surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases
title Surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases
title_full Surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases
title_fullStr Surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases
title_full_unstemmed Surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases
title_short Surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases
title_sort surgery for elastofibroma dorsi: optimizing the management of a benign tumor—an analysis of 70 cases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330361/
https://www.ncbi.nlm.nih.gov/pubmed/32642092
http://dx.doi.org/10.21037/jtd-20-649
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