后胸壁弹力纤维瘤19例临床分析  

Clinical diagnosis and treatment experience of 19-case elastofibroma dorsi

作　　者：杨海平[1] 吴骏[1] 王立杰[1] 孙林[1] 李卫强[1] 刘彤[2] 杨建杰[2] 

机构地区：[1]首都医科大学潞河教学医院胸心外科,北京101149 [2]首都医科大学潞河教学医院病理科,北京101149

出　　处：《中国综合临床》2012年第6期573-576,共4页Clinical Medicine of China

摘　　要：目的探讨后胸壁弹力纤维瘤的诊断及治疗方法。方法回顾性分析2001年10月至2011年10月在我院住院后胸壁弹力纤维瘤19例患者的临床资料，总结弹力纤维瘤的临床特点、特征性的影像学表现、典型的病理改变、近远期手术疗效。结果19例患者发病部位均为肩胛下角，3例为双侧病变，16例为单侧病变。12例患者偶然发现后胸壁无痛性肿物，7例局部疼痛不适伴上肢活动时后胸壁异物感。除早期6例外，近期13例患者在手术前未依赖组织学检查而依据典型发病部位（肩胛下）及典型影像学确诊。19例均行肿物切除术，肿物长径3—10cm，术后并发症为伤口积液1例，渗血1例。穿刺抽液后积液消失，给予止血药物、输血及局部加压包扎后渗血停止。手术后随访6～48个月，无复发。结论弹力纤维瘤常见于老年女性患者，肩胛下角区域为主要发病部位。详细的体格检查及影像学检查在术前即可做出正确诊断。手术治疗的近、远期效果良好。Objective To explore the experience in the diagnosis and treatment of elastofibroma dorsi. Methods Clinical data of 19 cases of pathologically confirmed elastofibroma from October 2001 to October 2011 were reviewed. The clinical features, the specific radiological characteristics, the typical pathological alterations and the short-term and long-term effects were analyzed. Results All the lesions were located within the muscles in the subscapular region. There were 3 cases with bilateral lesions and 16 cases with unilateral lesions. Seven patients complained of local pain and feeling of foreign body when activated the upper limb, while 12 were asymptomatic. Except for the early 6 cases, accurate diagnosis was rpade in all the other 13 cases before the histological exams solely based on the physical examination and imhging findings. Marginal excision was done for all the cases： the diameters of the masses were betwee~ 3 centimeters to 10 centimeters. Fluid accumulation complications was found in 1 case and resolved by repeated paracentesis;errhysis complication,was found in 1 case and resolved by compression, applying hemostatics and blood transfusion. No recurrence was found during the follow-up period（6 months to 48 months）. Conclusion Elastofibroma dorsi is usually found in the subscapular region in elderly women. The diagnosis can be made on the basis of unique imaging characteristics and physical examination before histological examine. Surgical marginal excision can achieve good short-term and long-term effects.

关 键 词：弹力纤维瘤 软组织肿瘤 外科手术 

分 类 号：R734.4[医药卫生—肿瘤]