Bilateral Elastofibroma as an Unusual Cause of Shoulder Pain

Elastofibroma dorsi: 8 case reports and a literature review

“…These lesions tend to be slowly growing and asymptomatic in more than 50% of the cases. When symptoms are present, they are typical, consisting of local scapular swelling and a clunking sensation during abduction and adduction of the shoulder, with pain of moderate or, rarely, severe entity [ 2 , 3 , 5 ].…”

Avaliação por imagem dos elastofibromas da cintura escapular

“…It does not reach the skin. 1,5,6,10,14 Diagnosis can be made by imaging methods. Conventional radiology is usually normal, but height scapular asymmetry has been described in some cases.…”

“…It presents a slightly heterogeneous enhancement. 5,6,10,14,15 Magnetic resonance imaging is the method of choice for diagnosis. The mass appears as a solid expansive formation, ill-defined, nonencapsulated, heterogeneous, and localized anterior or caudal to the inferior pole of the scapula, and deep in relation to the muscles latissimus dorsi, rhomboid and serratus anterior.…”

“…It presents a predominant iso-signal to muscles (fibrous tissue), and, characteristically, alternated stripes or lines of hypersignal on T1 and T2 interspersed (adipose tissue) ( Figures 2A, 2B and 2C). 1,6,5,10,14 Small lesions may not be detected because their signal is similar to muscles (Figures 3 and 4). Occasionally, they can present a heterogeneous enhancement through paramagnetic contrast (gadolinium), which hinders its distinction from malignant lesions, such as sarcomas ( Figures 2D and 2E).…”

“…Thick needLe biopsy is needed for diagnostic confirmation in case of a symptomatic fast-growing tumor. 1,2,5,10,14 Surgical excision must be large, including the skin, the hypodermic tissue and, when necessary, the deeper tissue. Erasion or puncture biopsy are not sufficient procedures.…”