Elastofibroma dorsi: A soft tissue masquerade

Abstract

Elastofibroma dorsi (ED) is a soft tissue tumor found in the subscapular region. The pathogenesis of ED is unclear, but may involve a regenerative or reactive hyperproliferation due to mechanical microtrauma. Magnetic resonance imaging (MRI) is preferred to diagnose ED and complete excision is curative. When bilateral, subscapular masses are identified in the elderly patient and MRI characteristics are typical, biopsy and excision can be avoided. Symptomatic EDs should be excised, and recurrence is rare. Three hundred and thirty cases of ED have been reported since 1980. Fourteen case series and 43 isolated case reports involved 263 women and 67 men (F:M ratio = 3.9:1), with a mean age of 62 years (range 6–94 years). Bilateral ED was present in 164 patients and unilateral ED in 157. The reported prevalence in the elderly population ranges from a minimum of 2% to a maximum of 24%.

Painful Elastofibroma Dorsi: A Report of a Case and a Brief Review of the Literature

“…Elastofibroma dorsi affects primarily the elderly, over 55 years of age, with a mean age of about 60 years at diagnosis [2]. However it is not impossible even for children to present with ED [27, 31].…”

“…However it is not impossible even for children to present with ED [27, 31]. Bilateral EDs seem to be quite common, up to 50% of the cases [2, 28]. ED unanimously is present more frequently in women rather than men (F : M ratio 3,9 : 1) [2].…”

“…Bilateral EDs seem to be quite common, up to 50% of the cases [2, 28]. ED unanimously is present more frequently in women rather than men (F : M ratio 3,9 : 1) [2]. The prevalence of the tumour in the elderly population varies from a low 2% as estimated with the use of CT [32] up to a high 24% for women and 11% for men in an autopsy series [28].…”

“…The physical examination may reveal a palpable, firm mass at the lower corner of the scapula, more prominent on abduction of the arm, usually immobile and probably due to its adherence to the surrounding tissue. Another mass may be present on the opposite shoulder, often smaller and clinically silent [2, 6, 21, 27, 33, 34]. …”

“…This fact not only limits the unanimous characterization of the tumour regarding conservative, surgical, and postoperative followup, but also strengthens the misbelief that ED is an extremely rare condition. Go et al in a recent review of the literature identified 330 cases of elastofibroma between 1980 and 2009 [2]. We herein report a case of a symptomatic, unilateral ED in a 65-year-old woman, and we briefly perform a PubMed research adding 161 cases of ED from 2009 up today in the already existing literature [3–26].…”