Bilateral elastofibroma dorsi: proper positioning for an accurate diagnosis

Abstract

Elastofibroma dorsi is a rare, slow-growing, ill-defined soft tissue tumor of the chest wall, most commonly located beneath the rhomboid major and latissimus dorsi muscles. It is usually unilateral, and bilateral involvement occurs in only 10% of patients. We report herein a case of a 56-year-old woman with bilateral elastofibroma dorsi. The patient was found to have bilateral involvement of the tumor following a physical examination with proper positioning. An elastofibroma should be considered in the differential diagnosis of tumors deeply located at the periscapular area. Meticulous physical examination may reveal a nonpalpable coexisting tumor with deep subscapular location and help the accurate diagnosis of bilateral elastofibroma dorsi, hence preventing a secondary operation.

A rare tumor of the chest wall: Elastofibroma Dorsi

“…The tumor was first described by Jarvi and Saxen in 1961 3,4 . The tumor is more prevalent in females aged over 50 5 .…”

Elastofibroma dorsi: Review of eight cases

“…9,10 As none of these fi ndings and hypotheses can explain the pathogenesis of all ED cases with various anamneses and localizations, we assume that the etiology is multifactorial. 11 Although the lesion is seen frequently in patients over 55 years of age, there is one case report of a 6-year-old child with ED. 12,13 The mean age in our series was 55.5 years, which is consistent with the literature data.…”

“…Needle aspiration or incisional biopsy can be done to confi rm the ED diagnosis, but excisional biopsy or at least core needle biopsy is preferred. [4][5][6]8,11 Daigeler et al performed core needle biopsy for the preoperative diagnosis in three of seven patients, but operated on the other patients without any preoperative histopathological confi rmation. 6 Other authors recommend that biopsy should not be mandatory, even for patients who will not undergo surgery, if there is solid clinical and radiological evidence that the lesion is ED.…”

Elastofibroma Dorsi

“…The rate of bilateral involvement has been reported as 10%. 9 This lesion characteristically is located at the subscapular-infrascapular region and between rhomboid major and latissimus dorsi muscles, causing periscapular pain, discomfort, and loss of range of motion. 10 During movement of the arm and shoulder, a discomforting click may be present.…”