ﮔﺰارش ﯾﮏ ﻣﻮرد اﻻﺳﺘﻮﻓﺎﯾﺒﺮوﻣﺎ دورﺳﯽ دو ﻃﺮﻓﻪ

A Case Report of Bilateral Elastofibroma Dorsi

اﻻﺳﺘﻮﻓﺎﯾﺒﺮوﻣﺎ دورﺳﯽ ﯾﮏ ﺗﻮﻣﻮر ﺧﻮشﺧﯿﻢ در ﻧﺎﺣﯿﻪ ﺧﻠﻔﯽ ﺟﺪاره ﻗﻔﺴﻪ ﺳﯿﻨﻪ ﻣﯽﺑﺎﺷﺪ. در ﺑﻌﻀﯽ از ﺑﯿﻤﺎران اﯾﻦ ﺿﺎﯾﻌﻪ ﺑﻪ ﺻﻮرت دو ﻃﺮﻓﻪ و ﻗﺮﯾﻨﻪ ﺑﺮوز ﻣﯽﮐﻨﺪ. در اﯾﻦ ﻣﻘﺎﻟﻪ آﻗﺎي 62 ﺳﺎﻟﻪ ﮐﺸﺎورزي ﮐﻪ ﺑﺎ ﺷﮑﺎﯾﺖ ﺗﻮده در ﻗﺴﻤﺖ ﺧﻠﻔﯽ ﻗﻔﺴﻪ ﺳﯿﻨﻪ و زﯾﺮ ﮐﺘﻒ راﺳﺖ ﻣﺮاﺟﻌﻪ ﮐﺮده ﻣﻌﺮﻓﯽ ﻣﯽﮔﺮدد ﮐﻪ ﭘﺲ از اﻧﺠﺎم ﺑﺮرﺳﯽﻫﺎي ﺗﺼﻮﯾﺮ ﺑﺮداري و ﭘﺎﺗﻮﻟﻮژﯾﮏ ﺑﺎ ﺗﺸﺨﯿﺺ ﺗﻮﻣﻮر ﺟﺪاره ﻗﻔﺴﻪ ﺳﯿﻨﻪ ﻣﻮرد ﻋﻤﻞ ﺟﺮاﺣﯽ رزﮐﺴﯿﻮن ﺗﻮده ﻗﺮار ﮔﺮﻓﺖ. ﺗﻮﻣﻮر ﺑﺎ اﺑﻌﺎد 6×6 ﺳﺎﻧﺘﯿﻤﺘﺮ ﺑﻪ ﻃﻮر ﮐﺎﻣﻞ و ﺑﺎ ﻣﺎرژﯾﻦ ﺳﺎﻟﻢ ﺑﺮداﺷﺘﻪ ﺷﺪ ﮐﻪ ﭘﺎﺗﻮﻟﻮژي اﻻﺳﺘﻮﻓﺎﯾﺒﺮوﻣﺎ دورﺳﯽ ﮔﺰارش ﮔﺮدﯾﺪ. ﭘﺲ از ﮔﺬﺷﺖ ﯾﮏ ﺳﺎل ﻣﺸﺎﺑﻪ ﻫﻤﺎن ﺗﻮﻣﻮر در ﺳﻤﺖ ﭼﭗ رﺷﺪ ﮐﺮد و ام آر آي ﻧﯿﺰ ﺗﺸﺨﯿﺺ را ﺗﺄﯾﯿﺪ ﮐﺮد. ﻟﺬا ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺑﺪون ﻋﻼﻣﺖ ﺑﻮدن ﺑﯿﻤﺎر، درﻣﺎن ﺟﺮاﺣﯽ در دﺳﺘﻮر ﮐﺎر ﻗﺮار ﻧﮕﺮﻓﺖ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻧﺎدر ﺑﻮدن ﺿﺎﯾﻌﻪ و ﺑﺮﻧﺎﻣﻪﻫﺎي ﺗﺸﺨﯿﺼﯽ و درﻣﺎﻧﯽ ﻣﺘﻌﺪدي ﮐﻪ ﺑﺮاي اﯾﻦ ﺑﯿﻤﺎران ﭘﯿﺸﻨﻬﺎد ﻣﯽﺷﻮد ﺑﻪ اراﯾﻪ اﯾﻦ ﻣﻮرد ﭘﺮداﺧﺘﯿﻢ. ﻫﻤﭽﻨﯿﻦ در اﯾﻦ ﺑﯿﻤﺎر دو روش ﻣﺨﺘﻠﻒ درﻣﺎﻧﯽ، ﺟﺮاﺣﯽ و درﻣﺎن ﻣﺤﺎﻓﻈﻪ ﮐﺎراﻧﻪ ﺑﺮاي دو ﺗﻮﻣﻮر در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪ ﮐﻪ ﻣﯽﺗﻮاﻧﺪ ﺳﯿﺮ ﻃﺒﯿﻌﯽ ﺑﯿﻤﺎري را ﻧﺸﺎن داده و ﻧﺘﺎﯾﺞ دو روش درﻣﺎﻧﯽ را ﻣﻘﺎﯾﺴﻪ ﮐﻨﺪ.

Elstofibroma dorsi is a benign and rare tumor that grows in dorsal aspect of thoracic cage muscles. In some patients this occurrence is bilateral. We present a 62 years old farmer man who referred due to a mass in dorsal part of right hemi thorax and inferior to scapula. After pathologic and radiologic evaluation an approximately 6×6 cm tumor was resected with free pathologic margins that final pathologic report was compatible with elastofibroma dorsi. Nearly after one year another tumor appeared in symmetrically in left side beneath scapula that the diagnosis of elastofibroma dorsi was assumed by CT and MRI. Patient was asymptomatic so follow up and observation selected for patient