Diffusion MR: A New Diagnostic Tool for Elastofibroma Dorsi

Elastofibroma dorsi is a benign lesion commonly presents as a palpable enlarging mass at the inferior pole of the scapula. Clinical presentation and radiological characteristics are often enough to suggest an accurate diagnosis. Increased awareness of the characteristic appearance and location of these benign lesions will increase radiologic diagnosis and decrease the need for biopsy.
Ten patients were admitted with a complaint of asymptomatic or painful subcutaneous masses localized at subscapulary region. Thorax computed tomography, magnetic resonance imaging (MRI) and a new feasible technique in differential diagnosis with malignancy and probable diagnosis of elastofibroma dorsi and diffusion-weighted MRI were used for diagnosis.
Surgery was applied to all patients, frozen-section biopsies of the lesions at the preoperative period, and final pathologies were all benign. Totally resection of whole lesions as en-bloc excision without any rest was performed at all patients. Postoperative and follow-up periods were uneventful.
Diffusion MRI can play an important role in the future and save the patients, especially medically poor ones, from the potential risks of surgery. Necessary further examinations for probable bilaterally lesions will save the patient from the risk of a second operation.

Difüzyon MR: Elastofibroma dorsi’de yeni taný aracý

Amaç: Elastofibroma dorsi (ED) sýklýkla skapula alt polünü içeren bölgede ele gelen þiþlik þeklinde büyüyen kitle lezyon olarak ortaya çýkar. Nadir bir benign neoplazi olan ED’nin klinik prezentasyonu ve radyolojik karakterizasyonu ön-taný için yeterli olabilmektedir. Karakteristik özelliklerinin görüntüleme yöntemleri ile daha net ortaya konmasý özellikle riskli vakalarda biyopsi ve eksizyonel cerrahi uygulanmadan tanýya gidiþi kolaylaþtýracaktýr.
Metod: Asemptomatik ya da aðrýlý cilt altý lezyon ile klinikte görülen 10 hasta deðerlendirildi. Toraks Bilgisayarlý Tomografi (BT), Manyetik Rezonans (MR) Görüntüleme ve ayýrýcý tanýda yeni ve daha faydalý bir tetkik olabilecek Difüzyon - MR hastalarýn deðerlendirilmesinde kullanýldý.
Sonuçlar: Tüm hastalara cerrahi uygulandý. Peroperatif frozen-section biyopsi ile taný alýnarak total eksizyon gerçekleþtirildi. Kesin patoloji sonuçlarý da ‘benign’ olarak öðrenilen hastalarýn postoperatif dönem ve takipleri sorunsuz idi.
Tartýþma: Difüzyon-MR radyolojik olarak belirli kriterlere dikkat çekerek nadir ve benign bir tümör olan elastofibroma dorsi tanýsýnda daha aktif kullaným ile riskli hasta grubunda majör bir cerrahiden kurtarabilir. (SETB-2018-02-024)