Elastofibroma Dorsi Research Articles

Angiomatoid Fibrous Histiocytoma Initially Misdiagnosed as Elastofibroma Dorsi: A Case Report and Literature Review

Background and Objectives: Angiomatoid fibrous histiocytoma (AFH) is a rare soft-tissue tumor with a low-grade malignancy. It typically arises in superficial soft tissues of the extremities, head, neck and trunk in children or young adults. Because of its rare entity, it tends to be confused and misdiagnosed. Materials and Methods: A 12-year-old male presented with a painless mass located on his right upper back. The CT finding showed a 7.3 × 2.8 × 5.4 cm-sized, well-defined heterogeneous soft tissue mass in the right infrascapular area. We performed a complete excision, including the surrounding capsule. Result: The final pathology revealed an AFH of intermediate malignancy. On pathologic examination, the lesion was a 5.8 × 4.5 × 2.6 cm-sized mass with a mitotic count of 12/10 HPF, tumor necrosis of 0% and marked increased cellularity and spindle cell morphology. The immunohistochemical study showed negative for S100 and positive for SMA, focal positive for Ki-67, CD68 and positive for CD99, Desmin staining. During the five years of follow-up period, he did not show any evidence of recurrence. Conclusions: The result was satisfactory. We report a case of AFH of the back initially misdiagnosed as an elastofibroma dorsi (ED) with the review of the literature for this uncommon entity.

A 78-Year-Old Man with Elastofibroma Dorsi Presenting as a Left Subscapular Mass

A 78-Year-Old Man with Elastofibroma Dorsi Presenting as a Left Subscapular Mass

Elastofibroma Dorsi: experience of a single center

Elastofibroma Dorsi: experience of a single center

Elastofibroma Dorsi: experience of a single center.

Elastofibroma dorsi (ED) is a rare benign tumor located in the subscapular region. The aim of this study was to evaluate our clinical findings, surgical approach, and management of ED patients based on single-center data with the relevant literature. A retrospective evaluation was conducted on 20 patients who were operated on for ED. Of the 16 (80%) female patients and 4 (20%) male patients, the main complaint was swelling (80%), and 10 cases (50%) had unilateral involvement. All patients were operated on using standard surgical procedures. Despite a long follow-up period (6-53 months, mean of 26.6 months), no recurrences were observed. Two patients (10%) required simple needle aspiration due to post-operative seroma, and one patient, due to infection, required evacuation (5%). Although rare, ED should not be overlooked in patients with swelling in the back region. Our data suggests that surgery can be safely performed in such patients after a clinical and radiological diagnosis of ED has been established.

Imaging Diagnosis of Thoracic Elastofibroma Dorsi.

Elastofibroma dorsi (ED) is an uncommon benign tumor that is commonly incidentally discovered on thoracic imaging and at times misinterpreted as a more aggressive lesion. The objective of the study is to characterize the typical cross-sectional imaging findings of elastofibroma dorsi and quantify the risk of masquerading malignancy. Retrospective search of radiology and pathology reports over a 12-year period identified 409 cases of suspected ED. Pertinent imaging was reviewed with a focus on computed tomography (CT) and magnetic resonance imaging (MRI), specifically assessing lesion location, presence of interspersed fat, and appearances on follow-up. Typical imaging appearances of 310 ED, including 10% with pathologic confirmation, were that of a mass deep to the serratus anterior (98%) and near the scapular tip (98%). Intralesional interspersed fat was present in 87% of cases imaged with CT and in 90% of cases imaged with MRI. In the 43 cases imaged with both modalities, 8 (19%) did not have interspersed fat on CT, but 7 (88%) of these did have interspersed fat on MRI. Twelve tumors (benign and malignant) were included, of which only 17% were deep to serratus anterior and 25% were at the scapular tip, P = 0.0001 and P < 0.0001 versus ED. Only a single tumor contained interspersed fat, P < 0.001 versus ED, which had benign pathology on biopsy. Elastofibroma dorsi can be diagnosed with a high degree of certainty in the presence of classic location and imaging characteristics, obviating the need for further imaging or biopsy.

Superior scapular location: An overlooked albeit frequent finding in elastofibroma dorsi

PurposeTo explore the frequency of superior scapular elastofibroma dorsi in a large patient series with elastofibroma dorsi. Methods136 chest CTs from January 2016 to July 2022 reporting elastofibroma dorsi were retrospectively analyzed. Three radiologists assessed the number, size, and location of elastofibroma dorsi. Continuous variables underwent two-tailed t-tests with p < 0.05. Inter-observer agreement was assessed by using Cohen's Kappa values. ResultsIn 136 patients (mean age, 75.9 +/− 9.8 years; 117 female), 330 elastofibroma dorsi were found. Six (4.4 %) patients had single, 87 (64 %) double, 22 (16.2 %) triple and 21 (15.4 %) quadruple lesions. All single and double lesions were in the inferior scapular regions. 43 (31.6 %) patients had superior scapular lesions in addition to inferior scapular elastofibroma dorsi. Inferior scapular elastofibroma dorsi was significantly larger than superior scapular elastofibroma dorsi. The probability of a right superior lesion was significantly higher in patients with a larger right inferior lesion. Inter-observer agreement was very good for experienced radiologist (κ = 94.1) and good for other radiologists (κ = 79.4 and κ = 78). ConclusionIn contrast to current belief, superior scapular elastofibroma dorsi accompanying the typical inferior scapular lesions is not uncommon and can even manifest bilaterally. To the best of our knowledge, this is the first case series reporting prevalence of quadruple elastofibroma dorsi.

"Under the Shoulders of Giants - Bilateral Elastofibroma Dorsi

Elastofibroma dorsi is a rare type of slow-growing benign pseudotumour with a higher prevalence in women over the age of fifty, and knowledge about its physiopathology is still in its early stages. The tumour typically affects predominantly one side but can, however, occur bilaterally. Surgical intervention is usually curative when performed with adequate margins. Due to its rarity, few cases are reported in the current literature. This study presents a case of symptomatic bilateral Elastofibroma dorsi in a 64-year-old female patient. Key Words - Thoracic Surgery; Surgical Oncology; Tumors.

Elastofibroma Dorsi Detected Incidentally on Chest Computed Tomography: The Prevalence and Reporting Rate in Radiology Reports.

Background Elastofibroma dorsi (ED) is an uncommon benign connective-tissue tumor, usually seen in the subscapular region of women after the fifth decade. The study aimed to determine the prevalence, radiological characteristics, and the rates of mentionin the initial radiology reports of ED incidentally detected by chest computed tomography (CT) imaging in a large population. Methodology This study was conducted at Hitit University, Erol Olçok Training and Research Hospital Radiology Department in Çorum, Turkey. A total of 3,299 patients (1,554 females, 1,745 males)who underwent non-contrast chest CT for various reasons were included in this retrospective study. The presence, side, thickness, and density of ED were investigated in these patients. Differences in gender and laterality were assessed statistically. It was also reviewed whether it was stated in the initial radiology report or not. Results ED was detected in 79 (2.4%) of 3,299 patients, in 60 (75.9%) females and 19 (24.1%) males with a median age of 57.5 years (range, 18-99 years). The risk of ED presence was determined to be 3.65-fold in females than in males. In the cases determined with ED, the median age was 75 years (range, 53-96 years), and ED was not determined in any patient aged <50 years. A statistically significant correlation was determined between age and the presence of ED (p < 0.001). No statistically significant correlation was found between age and ED thickness or density (p = 0.602, p = 0.233, respectively). It was noted that none of the patients were diagnosed in the first radiological report. Conclusions ED can be easily overlooked on cross-sectional examinations because of the similar appearance and density to adjacent structures. Knowledge of the characteristic radiological features of these lesions and increased awareness of radiologists will make early diagnosis possible in asymptomatic cases.

Elastofibroma dorsi’de BT bulguları: tek merkezli bir çalışmad

Aim: Elastofibroma dorsi (ED) is a benign pseudotumor detected by CT and/or MRI due to the penetration of fibrous and fatty tissues between the muscle structures and is more common in elderly people, especially in women, with subscapular topography. This study investigated the prevalence of elastofibroma dorsi in large series and CT findings.&#x0D; Material and Methods: A total of 469 patients (212 women, 257 men) who underwent thoracic CT for various reasons were included in this study. The presence, dimensions, contour and density of ED were investigated in these patients.&#x0D; Results: The mean age of 469 patients was 54.51±17.42 (18-88 years). Elastofibroma was detected in 15.4% (n=72) of these patients. It was determined that 69.9% (n=51) of the patients with ED were female, and the mean age of these patients was 63.21±15.72. ED was usually isodense in both sexes. Again, in both sexes, ED was more regularly contoured, and the fat planes between adjacent muscle structures were usually closed.&#x0D; Conclusion: Additional studies are not required when the lesion is typical and asymptomatic on CT scans. However, surgical treatment may be recommended if the lesion is symptomatic or if doubt remains regarding the benign nature of the lesion.

Elastofibroma Dorsi: Points for Discussion and Future Direction.

Elastofibroma Dorsi: Points for Discussion and Future Direction.

Elastofibroma Dorsi: Case Series of a Rare Chest Wall Pseudotumor.

Elastofibroma dorsi (EFD) is a pseudotumor of the thoracic wall that can be difficult to diagnose due to its rarity. Prompt recognition can limit unnecessary workup and expedite treatment. This study retrospectively analyzed patients with a diagnosis of EFD, discussing clinical presentations and surgical outcomes. This is an IRB-approved single-center retrospective study of all patients with a diagnosis of elastofibroma at our institution between 2000 and 2022. Ten patients were identified to have a pathologic diagnosis of EFD since 2000, with half presenting in the last 5years. Our cohort had an average age of 56.8years and was 50% female. The average age of male subjects was younger than females, 49.6-64.0years, respectively (p = 0.10). Eighty percent (8/10) of patients had unilateral EFDs and symptoms lasted 27.1months on average prior to diagnosis. Surgical resection was performed on 66.67% (8/12) of masses, with 87.5% (7/8) of patients who underwent surgery reporting complete resolution of their symptoms and none reporting recurrence. Although EFD is a rare pseudotumor, its incidence may be increasing. As such, surgeons should be aware of the typical clinical presentation; specifically, a slow growing, predominantly unilateral, painful, subscapular mass with an inhomogeneous pattern on imaging. Originally thought to predominantly affect elderly women, our study shows that younger men may be at risk as well. If patients present with EFD, complete surgical resection should be performed to achieve favorable outcomes and resolution of symptoms.

Elastofibroma dorsi: diagnóstico y seguimiento en atención primaria

ObjectiveTo present a series of patients with elastofibroma dorsi (ED) in order to recall the pathology and justify its diagnostic and therapeutic management in the primary care setting. Materials and methodsRetrospective observational and longitudinal study of 12 patients with 18ED. Epidemiological, clinical and imaging characteristics were analysed. Treatment outcomes were assessed in terms of pain (VAS scale), shoulder function (Constant and Murley scale) and quality of life (EuroQol-5 dimension scale, EQ-5D). The mean follow-up of the cases was 60.5months (5years, range 1-161months). ResultsSix patients were male and six were female, with a mean age at diagnosis of 59years. The diagnosis of suspicion in all cases was based in clinical and imaging findings. Only three required surgery. The results of all were satisfactory. ConclusionsBoth the diagnosis and the indication for treatment of an ED can be made in the primary care setting. In typical cases, which are the majority, the clinical history and an ultrasound study allow a diagnosis of certainty. The indication for conservative or surgical treatment depends on the informed patient. When there are diagnostic doubts or the patient wishes surgical resection of the tumour, the patient should be referred to a hospital specialist.

Marjinal rezeksiyon sonrası gelişen tek merkezli 31 elastofibroma dorsi vakalarında komplikasyonları etkileyen faktörler

Aim: Elastofibroma dorsi (ED) is an uncommon benign connective-tissue tumor, usually seen in the subscapular region of women after the fifth decade. We present the clinical features, management, and long-term outcomes of cases of ED treated surgically in a single institution.&#x0D; Material and Method: The data of 31 patients (7 male, 24 female) with a histopathological diagnosis of ED between January 2010 and January 2021 and mean age of 56.6 years were reviewed retrospectively from their records. The mean follow-up duration was 80.2 (19-144) months. Nine cases were bilateral. Marginal resection surgery was performed in all cases diagnosed radiologically and clinically, and preoperative biopsies were performed for three patients. The results were evaluated using a visual analogue scale (VAS) for pain during follow-up.&#x0D; Results: Complications such as chronic pain (n=5), hematoma (n=5), seroma (n=5), and infection (n=2) were seen in 11 patients (35%) in the early postoperative period and improved over the course of follow-up. A local recurrence observed in one patient during follow-up was re-excised. Significantly more complications were observed in patients with bilateral ED (p=0.015), manual laborers and heavy laborers (p=0.013), patients with comorbidities (p=0.006), those who slept in the supine position (p=0.031), and those who underwent synchronized surgery (p=0.013). In addition, statistically significantly more complications were observed in cases of masses with longer longitudinal length (p=0.016), patients with longer preoperative symptom duration (p=0.009), and longer operative times (p=0.025). The average VAS score improved significantly from 4.97 to 1.52 after surgery (p

Multifocal concomitant scapulothoracic and subgluteal-ischiofemoral elastofibromas

PurposeTo evaluate the frequency, imaging findings, and patient demographics of synchronous elastofibroma dorsi (ED) and pelvic elastofibromas. MethodsImage archives between 2011 and 2021 were retrospectively searched for CT and MRI reports including the keyword “elastofibroma”. Patients with concomitant CT and/or MRI of the chest and pelvic regions were included. The greatest thickness and side of ED were noted. Subsequently, pelvic soft tissues were evaluated for a soft tissue mass with similar radiological features to ED. When detected, its location, greatest transverse diameter, and ischiofemoral space widths were noted. Wilcoxon matched-pairs signed-rank and Mann-Whitney U-tests were performed when appropriate. Pearson’s correlations were used to assess the association of presence of subgluteal-ischiofemoral elastofibromas (SGIFE) and ED thickness. The model discrimination of ED thickness was evaluated by calculating the AUC of the ROC. ResultsEighty-eight patients (Male:Female = 8:80) with a mean age of 70.6 (±10.3) years were included. 96.6 % of patients had bilateral ED. 18.2 % of patients (all females) had at least one concomitant SGIFE. Patients with SGIFE had significantly thicker ED (p < 0.001 right; p = 0.049 left). There was a significant positive correlation between the thickness of ED and presence of SGIFE (r = 0.43, p < 0.001 right; r = 0.25, p = 0.019 left). An AUC of 0.781 (p < 0.001, 95 %-CI:0.675–0.887) and 0.659 (p = 0.049, 95 %-CI:0.523–0.794) were revealed regarding the presence of ipsilateral right and left SGIFE, respectively. ConclusionConcomitant SGIFE may accompany ED in up to 18.2% of cases, particularly in women with thick ED. Knowledge of this co-occurrence and the described SGIFE characteristics can facilitate correct diagnosis.

Subscapular elastofibrolipoma treated with marginal resection: two case reports

BackgroundElastofibroma dorsi is a rare benign tumor of soft tissue, typically under the lower angle of the scapula. Its specific location and distinctive clinical symptoms can provide enough information for diagnosis. Nevertheless, pathological confirmation by biopsy may be needed to rule out other malignancies.Case presentationHere, we present two cases of 63-year-old and 49-year-old female Asian patients who came to us with the chief complaint of pain and bulging in their shoulders. Both patients had rubbery and mobile masses. Also, shoulder movements were not restricted in the examination; however, the patients expressed pain during movements. Computed tomography scans were compatible with the diagnosis of elastofibroma dorsi. Surgical excision was performed for both cases owing to the symptomatic nature of the masses, and histopathological findings confirmed the diagnosis.ConclusionElastofibroma dorsi is a benign pseudotumor presenting with an uncomfortable feeling in the shoulder with movement in older females. In typical symptom-free cases of elastofibroma dorsi, observation is sufficient, while in symptomatic patients or if there is suspicion of malignancy, complete resection with marginal resection is the treatment of choice.

Relevance of Scapulothoracic joint assessment for unknown shoulder pain

The scapulothoracic joint (STJ) is one of the four joints forming the shoulder complex with the glenohumeral, acromioclavicular, and sternoclavicular. Abnormal motion of the scapula during shoulder movement is defined as scapular dyskinesia a distinct entity in the orthopedic literature as a source of posterior shoulder pain. Several acute and chronic conditions affecting one or more of the joints of the shoulder complex can result in disorders of the scapular motion. This article aims to provide a comprehensive review of the anatomy and function of the STJ, to describe the MRI features of the internal derangements of this articulation including scapulothoracic bursitis (or snapping scapula syndrome), elastofibroma dorsi, and other tumor and tumor-like lesions.

Does elastofibroma dorsi occur more frequently on the same side with the dominant hand?

Background In this study, we aimed to investigate the correlation between the side of elastofibroma dorsi formation and the dominant-hand of the patients we operated. Methods A total of 84 patients with elastofibroma dorsi (12 males, 72 females; mean age: 55.5±7.0 years; range, 43 to 74 years) were retrospectively analyzed between April 2007 and May 2019. Dominant hand, location, size, sex, age, occupations and follow-up of the mass were recorded and the pre- and postoperative Visual Analog Scale scores were noted. Results The mean symptom duration was 9.5±7.8 (range, 3 to 48) months. The lesions were located on the right in 49 (58.3%), on the left in 16 (19%) and bilateral in 19 (22.6%). There was no significant difference between the mass size and age, symptom duration and complication development (p=0.129). A significant relation was found between the formation of the mass on the side of the dominant hand (p=0.010). A significant difference was found between the pre- and postoperative Day 90 Visual Analog Scale scores (p<0.001), indicating a significant decrease in the pain scores. Conclusion Elastofibroma dorsi has good clinical results after surgical resection. In our series, the patients had significantly more elastofibroma dorsi on their dominant-hand side.

The Potential Use of Elastic Tissue Autofluorescence in Formalin-fixed Paraffin-embedded Skin Biopsies

Autofluorescence (AF) or naïve-florescence is the natural emission of light by biomolecules. During florescence microscope examination, we realized that elastic tissue is brighter or more autoflourescent than collagen and other biomolecules/cells in the skin. Consequently, we decided to review elastic tissue-related pathologies under a florescence microscope and to report the possible benefits of this technique from selected cases from the paraffin-block archive, by using the protease digestion immunofluorescence method. Selected and clinic-pathologically confirmed 3 elastofibroma dorsi, 3 pseudoxanthoma elasticum, 3 anetoderma, 3 arteriovenous malformations, 3 temporal arteritis, 3 scar tissue and 3 highly solar-damaged samples of skin from 2014-2019 were retrieved. Under the fluorescent microscope, coarse, thick and globularly-fragmented elastic fibers of elastofibroma dorsi, shortened, irregular and convoluted elastic fibers of pseudoxanthoma elasticum, internal elastic membranes of arteries and their integrity was visualized. None of the anetoderma cases had any signal representing elastic tissue. It was shown that elastic tissue can be observed easily under fluorescence microscope in the case of FFPE tissues. The resulting autofluorescence can be useful in recognizing elastic tissue-related pathologies, and it may be used as an ancillary or an alternative method to routine histochemical techniques.

Prevalence of elastofibroma dorsi found incidentally upon chest computed tomography scan: A tertiary care center experience.

Objectives:To determine the prevalence and demographic data regarding incidentally encountered elastofibroma dorsi (EFD) in the Saudi population-based on chest CT (computed tomography) scans.Methods:This retrospective study was carried out on 4,435 chest CT examinations that were collected between January 2014 and December 2016 in Riyadh, Saudi Arabia. One musculoskeletal radiologist who was unaware of the patients’ clinical presentations or reasons for CT study reviewed the 4,435 chest CTs prospectively, searching for soft tissue tumors in the subscapular region.Results:Elastofibroma dorsi was incidentally confirmed via CT scan in 36 of the 4,435 patients, including 8 males and 28 females, with a mean age of 76.6 years, yielding a prevalence of 0.8%. Elastofibroma dorsi was more common in females, with a 3.3-fold higher prevalence (77.8%) as compared to males (22.2%); however, this difference was not statistically significant (p>0.05). Twenty-five (69.44%) patients had unilateral EFD and 11 (30.56%) had bilateral EFD. Right-sided EFD was encountered in 60% of females and 50% of males. Furthermore, there was no statistically significant correlation between the size of EFD and the patient’s gender or age (p>0.05).Conclusion:Elastofibroma dorsi is a rare but uncommon incidental finding on routine chest CT examination encountered in 0.8% of elderly Saudi patients.

Peculiar thousand leaves soft-tissue mass: Elastofibroma dorsi.

Elastofibroma dorsi is an uncommon benign soft‐tissue tumor with uncertain pathogenesis (Medicina (Kaunas), 2021; 57, 370). Surgical excision is the therapeutic option for symptomatic patients. A pathological study confirms the diagnosis after surgery. The prognosis is excellent with extremely rare recurrence cases (Anticancer Res, 2021, 41, 2211).