両側の弾発現象を呈した肩甲骨下部弾性線維腫の2例

Bilateral Subscapular Elastofibromas Presenting with Snapping Scapula Symptoms. Report of Two Cases

　両側の弾発現象を呈した肩甲骨下部弾性線維腫を2例経験した．症例は49歳と48歳の男性でともに両側肩甲骨の深層に手拳大の腫瘤を認めた．腫瘤は共通して弾性硬，境界明瞭で，肩甲胸郭運動に関連して肩関節水平屈曲位で肩甲骨の弾発を呈した．2例とも両側の腫瘤摘出術を行い，背部痛および肩甲骨の弾発は消失した．病理にて弾性線維腫と診断された．本症は肩甲骨下部に好発し，肩甲骨の弾発を呈する場合がある．治療は無痛性腫瘤のみであれば経過観察でよいとされるが，背部痛や肩甲骨の弾発を認めれば腫瘤摘出術の適応となる．

　We report 2 cases of bilateral subscapular elastofibromas accompanied by snapping scapula. Both patients were middle-aged heavy-duty workers who had bilateral tumors with painful snapping scapula in subscapular regions. These tumors, which firmly adhered to the chest wall, were elastic, hard, and well-circumscribed. Bilateral scapulal snapping arose in events such as when the inferior pole of the scapula rubbed above the tumor related to thoracicoscapular motion. Both patients underwent en-block tumor resection and histological examination of these specimens confirmed the diagnosis of elastofibroma. Snapping scapula produced by elastofibroma is a relatively rare clinical condition in which patients report retroscapular pain and discomfort, and surgical care should be considered.