Management of Symptomatic Elastofibroma Dorsi: A Case Report and Literature Review.

Elastofibroma dorsi (ED) is a rare tumor that most often occurs in the subscapular and infrascapular region between the thoracic wall, serratus anterior, and latissimus dorsi muscle. Based on a review of the literature, ED has been deemed an extremely rare entity. However, the incidence may be greater and is difficult to determine as the majority of ED being asymptomatic and therefore undiagnosed. Surgical excision is commonly performed when patients present with pain associated with ED. This being the case, it is important to evaluate the factors contributing to the pain seen in these patients and to evaluate the risks vs benefits of intervening in symptomatic ED patients who present for possible surgical intervention. We herein report a case of bilateral ED, situated in the upper back with only the right side being symptomatic in a 56-year-old male laborer. Due to pain in the right upper back, the patient underwent surgical removal of the ED. The postoperative course was uneventful and the patient had an excellent recovery. A review of the literature showed no correlation between pain on presentation and tumor size or location. Major complications of treating these patients include seroma or hematoma formation which according to the literature can be avoided using postoperative tube drainage and compressing bandages.

Primary Splenic Epidermoid Cyst: A Case Report.

Primary splenic epidermal cysts, a type I splenic lesion, are very uncommon and usually found coincidentally. In this report, we present a primary splenic epidermal cyst that presented as a mass in the left upper quadrant associated with sharp pain, early satiety, and constipation. We review the classification of splenic cysts with a detailed look into the causes and types of type I cysts. We discuss the different treatment options, how current and past surgical options are controversial, and indications for splenectomy in spleen cysts. We explore how percutaneous drainage as a bridge to splenectomy may have been beneficial in a splenic cyst of great size. This splenic cyst was attempted laparoscopically but converted to an open splenectomy after complications. The patient recovered with no difficulties postoperatively.