Elastofibroma Dorsi, a Rare Condition, with Challenging Diagnosis. Case Report and Literature Review

Abstract

Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a case of a bilateral elastofibroma dorsi (ED) in a 65-year-old female who presented to the Department of General and Oncologic Surgery of Emergency Clinical Municipal Hospital Timisoara, Romania. The patient was symptomatic on the right side, presenting pain in the interscapulothoracic region associated with a variable tumoral mass, dependent on the position of the right arm. Imaging studies revealed a well-defined, bilateral tumoral mass with alternation of the muscular and fatty tissue. The initial diagnosis of lipoma was taken into consideration based on the CT scan and clinical findings. Surgical excision of the right subscapular tumor was performed without any postoperative complications. Microscopic examination of hematoxylin and eosin, Masson’s trichrome, and orcein stained slides revealed the diagnosis of ED. Considering the high rate of reported postoperative complications and the asymptomatic presentation of the contralateral subscapular mass, the patient underwent clinical and imagistic monitoring for the contralateral tumor. Due to its rare nature, ED is a difficult preoperative diagnosis that can, however, be suggested by its specific location and may require an accurate histopathological examination for a final diagnosis.

Unusual Late Complication of Latissimus Dorsi Free Flap Donor Site: Elastofibroma Dorsi

“… 8 A needle biopsy can be considered in rapidly enlarging lesions or those with atypical MRI characteristics or larger than 5 cm. 3 Surgical removal of the lesion is the recommended treatment, especially in symptomatic cases. Although in a recent study of 57 ED patients, Sahin et al discourage routine removal of ED regardless of its size, 9 considering there have been no cases of malignant proliferation following ED described in the literature.…”

“…8 A needle biopsy can be considered in rapidly enlarging lesions or those with atypical MRI characteristics or larger than 5 cm. 3…”

“…2 It seems to appear secondary to mechanical lesions due to altered scapulothoracic biomechanics during abduction, being suggested at the same time to occur as a result of tissue aging. 3 Generally asymptomatic, when symptoms are present, they usually include a palpable mass, mild pain, and functional restriction with snapping during the scapula movement. 4 Magnetic resonance imaging (MRI) demonstrates a lenticular, poorly circumscribed, heterogeneous soft-tissue mass.…”

Elastofibroma dorsi, causa rara de dolor torácico. Presentación de un caso

“…El tratamiento es quirúrgico si los síntomas o el crecimiento de la lesión lo ameritan y el pronóstico es muy bueno, con excepcionales casos de recurrencia por resección incompleta (6). En general, se considera que las lesiones asintomáticas menores de 5 cm pueden ser manejadas con observación y seguimiento y las lesiones mayores de 5 cm o con dolor persistente, deben ser resecadas como tratamiento óptimo (11). El pronóstico es excelente con recaídas extremadamente raras en los casos que requirieron resección quirúrgica (4).…”

Peculiar thousand leaves soft‐tissue mass: Elastofibroma dorsi

“…The histological differential diagnoses of elastofibroma include desmoid fibromatosis and fibrolipoma. 1 , 2 The postoperative course was uncomplicated. No adjuvant treatment was planned for this patient.…”