Elastofibroma dorsi: a radiological diagnosis

Abstract

Elastofibroma dorsi is a rarely made radiological diagnosis. The rarity of the condition, lack of a suitable imaging modality, and an inconsistent clinical approach in evaluating indeterminate soft tissue tumors has contributed to this failure. With magnetic resonance imaging now being recognized as the examination of choice for all indeterminate soft tissue tumors, a prebiopsy diagnosis can frequently be made by radiologists familiar with the characteristic periscapular location, predilection for elderly females, and short T2 on magnetic resonance imaging.

Elastofibroma dorsi: prevalence in an elderly patient population as revealed by CT.

“…Other research suggests that when a mass of interposed fat and soft tissue is lo cateddeep in relationto the scapula,no fur ther tests are needed to make the diagnosis of elastofibroma dorsi [8,10,12]. To our knowl edge,no previousstudyhassuggested thatbi opsyof homogeneous masses canbe avoided.…”

Sonographic detection of elastofibroma dorsi

“…22 Various modalities have been used in the evaluation of elastofibroma, and its features on imaging have been described. 7,12,[23][24][25][26] Plain radiographs usually appear normal but may occasionally show elevation of the scapula and a soft tissue mass in the subscapular and periscapular regions. 23 Bone erosion and invasion are rare, having been reported in only 1 case of an intraarticular elastofibroma.…”

“…7,12,23 MRI scans show a soft tissue mass that contains streaks of fat and has a signal intensity similar to that of skeletal muscle. 24 Some authors have suggested that the characteristic appearance of elastofibroma on MRI of linear and curvilinear regions of alternating high and intermediate signal intensity on T1-and T2-weighted images is sufficient to make a diagnosis without a biopsy. 24,25 Some elastofibromas have low signal intensity on T2-weighted images; this is a result of decreased cellularity and abundant collagen formation.…”

“…24 Some authors have suggested that the characteristic appearance of elastofibroma on MRI of linear and curvilinear regions of alternating high and intermediate signal intensity on T1-and T2-weighted images is sufficient to make a diagnosis without a biopsy. 24,25 Some elastofibromas have low signal intensity on T2-weighted images; this is a result of decreased cellularity and abundant collagen formation. 27 Despite the characteristic appearances reported using CT and MRI, detection of an elastofibroma can be difficult if it is obscured by adjacent similarappearing muscle or is compressed between the scapula and chest wall, as it was during the first MRI in our case.…”

A 70 Year-Old Woman with a Chest Mass

“…4 Location, female gender, and bilateralism in the elderly are strongly supportive characteristics. The abnormality seen is a well-or poorly-defined soft tissue mass in the subscapular region, with attenuation similar to skeletal muscle.…”