Elastofibroma: a literature review and clinical case

Abstract

Elastofibroma is a rare, slow growing, benign soft tissue tumor characterized by a typical location in the subscapularis. It has a mesenchymal origin and consists of proliferating fibrous and adipose tissue with elastic and collagen fibers in its composition. Pain and discomfort in the subscapular region, restriction on movement are typical complaints for patients with elastofibroma, however, the absence of clinical symptoms and difficult differential diagnosis make it difficult to choose treatment tactics. A 70-year-old patient applied to a surgeon at the Clinical Diagnostic Center of the Central Clinical Hospital of St Alexis with complaints of a painless tumor-like subcutaneous mass in the region of the lower angle of the right scapula. She noted the presence of this formation 5 years ago, during this time the tumor gradually grew. When viewed on the back along the lower edge of the right shoulder blade, a volumetric tumor-like formation in the form of a ball measuring 7.5 × 6.0 × 2.0 cm, soft-elastic consistency is determined. On palpation, painless, not soldered to the skin. The skin over the formation is not changed. A preliminary diagnosis was established lipoma of the back. The diagnosis of elastofibroma was established after ultrasound of the posterior chest wall, MSCT of the chest. For differential diagnosis, the puncture biopsy material was sent for histological examination, the result of which confirmed the diagnosis of elastofibroma. Observational tactics in this case is preferable, since elastofibroma is not accompanied by pain, limitation of mobility, and does not bring discomfort when moving. Thus, at the moment, imaging methods allow establishing an accurate diagnosis, but histological examination is necessary for differential diagnosis. However, a histologically confirmed diagnosis will not always be an indication for surgery. In most cases, in the absence of clinical manifestations, observational tactics are followed in the treatment.