Elastofibroma dorsi: Typical radiological features

Haykir, Rahime; Karaköse, Serdar; Karabacakoğlu, Aydın

doi:10.1111/j.1440-1673.2007.01786.x

Cited by 15 publications

(8 citation statements)

References 13 publications

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“…Typically, the pattern of alternative hyperechoic and hypoechoic lines parallel to the chest wall is seen. 18 CT shows a heterogeneous soft tissue mass, often similar to weakened margins similar to skeletal muscle. On MRI, the fat tissue shows higher signal characteristics compared to the mass.…”

Section: Discussionmentioning

confidence: 99%

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Is it necessary to always resect elastofibroma dorsi?

Sahin

Gul

2020

ANZ Journal of Surgery

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Background: Elastofibroma dorsi (ED) is a benign soft tissue tumour of the subscapular region of the chest wall. It is a frequent lesion, especially seen in females and in the elderly. It remains unclear whether the size or symptomatology of the tumour is important to make a resection decision. Our aim in this study is to reveal the results between asymptomatic or symptomatic ED cases, and to reveal which factors are important for making a resection decision. Methods: Patients operated between January 2010 and December 2019 were included in the study, and divided into two groups as patients who were asymptomatic or with various symptoms. Patients were evaluated in terms of demographic and operational factors. Results: The study included 57 patients with the average age of 56.1 AE 11.5 years. Whilst 31 (54.4%) of these patients were asymptomatic, 26 (45.6%) were symptomatic. There was a statistical significance between groups in terms of occupation (P < 0.001), comorbidity (P = 0.042) and the duration of complaints (P = 0.001). A statistically significant difference was analysed between comorbidity versus early and late complications (P = 0.011 and P = 0.002, respectively). Conclusion: ED probably occurs as a result of repeated trauma in the subcapular region in people who use their arms extensively. Regardless of the size of the lesion, surgery should be avoided as much as possible, especially in asymptomatic patients. However, in patients who are symptomatic, a precise surgical procedure can give satisfactory results. In these patients, who are generally elderly, early and late complications can be seen more, if they have comorbidity.

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Section: Discussionmentioning

confidence: 99%

“…USG shows an abnormal mass in the subscapular region. Typically, the pattern of alternative hyperechoic and hypoechoic lines parallel to the chest wall is seen 18 . CT shows a heterogeneous soft tissue mass, often similar to weakened margins similar to skeletal muscle.…”

Section: Discussionmentioning

confidence: 99%

Is it necessary to always resect elastofibroma dorsi?

Sahin

Gul

2020

ANZ Journal of Surgery

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“…This concept has been reinforced by other studies, particularly when used to supplement CT and MRI. [30][31][32][33] Battaglia et al 34 studied 43 patients with proven elastofibroma using ultrasonography followed by CT and MRI. It was shown that, if a typical fasciculated pattern was evident on ultrasonography, elastofibroma could be diagnosed.…”

Section: Discussionmentioning

confidence: 99%

“…Although four of our earlier patients had a CTguided biopsy, this is no longer our standard practice since current evidence suggests that the lesion can be confidently diagnosed by radiological investigation alone if typical clinical features are present. [30][31][32][33][34][35][36] No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.…”

Section: Discussionmentioning

confidence: 99%

Elastofibroma dorsi: management, outcome and review of the literature

Parratt

Donaldson

Flanagan

et al. 2010

The Journal of Bone and Joint Surgery. British volume

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Elastofibroma dorsi is an uncommon, benign, slow-growing soft-tissue tumour of uncertain aetiology. It classically presents as an ill-defined mass at the inferior pole of the scapula with symptoms which include swelling, discomfort, snapping, stiffness and occasionally pain. We report the symptoms, function and outcome after treatment of 21 elastofibromas in 15 patients. All were diagnosed by MRI and early in the series four also underwent CT-guided biopsy to confirm the diagnosis. In all, 18 tumours were excised and three were observed. After excision, the mean visual analogue score for pain decreased from 4.6 (0 to 10) pre-operatively to 2.4 (0 to 8) post-operatively (p = 0.04). The mean shoulder function, at a mean follow-up of 4.2 years (3 months to 16 years), was 78.1% (30 to 100) using the Stanmore percentage of normal shoulder assessment scoring system. The mean range of forward flexion improved from 135 degrees (70 degrees to 180 degrees ) to 166 degrees (100 degrees to 180 degrees ) after excision (p = 0.005). In four patients a post-operative haematoma formed; one required evacuation. Three patients developed a post-operative seroma requiring needle aspiration and one developed a superficial infection which was treated with antibiotics. Our findings support previous reports suggesting that a pre-operative tissue diagnosis is not necessary in most cases since the lesion can be confidently diagnosed by MRI, when interpreted in the light of appropriate clinical findings. Surgical excision in symptomatic patients, is helpful. It has been suggested that elastofibroma is caused by a local tissue reaction and is not a true neoplastic process. A strong association has been noted between elastofibroma and repetitive use of the shoulder, which is supported by our findings.

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“…It is rather the collaboration between clinicians and radiologists that can suggest the preoperative suspicion of ED [21,22]. Several papers in the recent literature indicate that imaging studies should be enough if the lesion is unilateral or asymmetrical, painful, with hard consistency, and rapidly progressing in volume [23][24][25]. Development of a tumoral mass in that specific region can include a number of differential diagnosis such as: Hemangioma, neurofibroma, malignant histiocytoma, lipoma [7,26,27], and requires an MRI with gadolinium contrast, thus the malignant tumors can be differentiated [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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Elastofibroma dorsi: Typical radiological features

Cited by 15 publications

References 13 publications

Is it necessary to always resect elastofibroma dorsi?

Is it necessary to always resect elastofibroma dorsi?

Elastofibroma dorsi: management, outcome and review of the literature

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

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