Abstract
Elastofibroma dorsi is an uncommon benign soft tissue pseudotumour usually located at the lower pole of the scapula, deep to serratus anterior, and often attached to the periosteum of the ribs, presenting with long history of swelling and occasionally pain and discomfort. This lesion is usually seen in patients over the age of 50 years and is not uncommonly mistaken as a malignant tumour because of its size and location deep to the periscapular muscles. Review of the orthopaedic oncology database of 17 500 patients revealed that there were 15 patients with elastofibroma dorsi. There were 12 males and 3 females, mean age at diagnosis of 68.4 years range 51–79 years. The diagnosis was confirmed by MRI in 3 patients, excision biopsy in 3 patients, trucut biopsy in 8 patients and open biopsy in 1 patient. Eight patients had excision of the lesion which was symptomatic. There have been no recurrences. We highlight the clinical and radiological presentation of elastofibroma dorsi to increase awareness of its existence and management.
Highlights
Elastofibroma dorsi is an uncommon benign soft tissue pseudotumour usually located at the lower pole of the scapula, deep to serratus anterior, often attached to the periosteum of the ribs, presenting with a long history of swelling and occasionally pain and discomfort in elderly patients
Elastofibroma dorsi is an uncommon benign soft tissue pseudotumour occurring in the infrascapular region of elderly patients
The size of the lesion, location deep to the deep fascia, and attachment to the ribs suggest the possibility of soft tissue sarcoma
Summary
Elastofibroma dorsi is an uncommon benign soft tissue pseudotumour usually located at the lower pole of the scapula, deep to serratus anterior, often attached to the periosteum of the ribs, presenting with a long history of swelling and occasionally pain and discomfort in elderly patients. If the lesion is unilateral, the MRI appearance of a poorly circumscribed, heterogeneous soft tissue mass, occasionally enhanced by gadolinium, makes it difficult to exclude a soft tissue sarcoma with complete confidence. This necessitates the need for biopsy to confirm the diagnosis. We describe our experience of treating 15 patients with elastofibroma dorsi
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