彈性蛋白纖維瘤：病例報告及文獻回顧

Elastofibroma: Case Report and Literature Review

彈性蛋白纖維瘤是一種少見的，生長緩慢的良性軟組織瘤。主要生長的位置是介於肩胛骨與胸壁之間，年長的婦女比較容易發生，它發生的原因是肩胛骨與胸壁不斷的磨擦造成的傷害。文獻上的病例報告不多，因此真正的發生率並不清楚，台灣發表的文章也只有五篇。彈性蛋白纖維瘤的組織變化是以膠原蛋白為背景，加上彈性蛋白纖維、脂肪組織所形成的間質軟組織瘤。本文報告一例無論是年齡、性別、部位、臨床症狀都與其他報告一致。這是一個有趣的病例因為它在H&E染色時不容易診斷；但是用Elastin染色，腫瘤特徵很容易突顯出來，免疫組織化學染色對診斷沒有幫助。這篇文章主要報告的是病人兩側背部都發生彈性蛋白纖維瘤，第一次於1992年發生在右側，第二次於2002年長在左側，接受手術後目前病人完全正常沒有復發的跡象。

Elastofibroma is a rare, slow growing benign soft tissue tumor typically located between the scapula and the chest wall in elderly women resulting from trauma caused by repeated friction of the scapula and chest wall. There are few cases reported in the literature and the exact number of incidences is not clear. Histologically, elastofibroma is a mesenchymal soft tissue tumor intermingled with fat and elastic fibers in a collagen fibrous background. The case reported is of typical age, gender, site, and clinical symptoms. This particular case is interesting due to the fact that it was difficult to make a diagnosis using an H & E stain alone, but relatively simple to diagnose with the help of a chemical Elastin stain. The immunohistochemical stain was not essential. The bilateral involvement of the tumor was the interesting aspect of the case. The patient suffered from the same problem twice in a 10 years interval. One incident occurred on the right side of back in 1992 and the second incident on the left side of the back in 2002. At this time, 2008, the patient has recovered from the most recent incidence.