Elastofibroma Dorsi Research Articles

Management and Outcome of Bilateral Elastofibroma Dorsi: 3 Cases Report and Review of Literature

Elastofibroma dorsi is a rare soft tissues benign tumor with very slow evolution, seen predominantly in females and elderly, It mostly occurs in the infrascapular region, and can be bilateral. The diagnosis is based on clinical presentation and imaging features but pathological study after excision is necessary for confirmation. We present the cases of 3 patients with bilateral elastofibroma dorsi to clarify the clinical features, radiological and therapeutic modalities to improve management, along with a literature review.

Elastofibroma Dorsi: Our experience in a tertiary care hospital of Himalayan region

Introduction: Elastofibroma dorsi (ED)is a rare, benign, connective tissue tumour typically occurring in the posterior thoracic wall between serratus anterior and lattismus dorsi muscle adjacent to the inferior angle of the scapula. Actual aetiology remains unknown, and classical clinical features, which include swelling, pain and discomfort in the scapular region along with MRI, usually confirm the diagnosis. Methods: In our study, we described 11 patients with elastofibroma dorsi from 2014 to 2021 identified retrospectively treated with marginal excision. The patient’s age, gender, lesion side, tumour size, and location were analysed in addition to intraoperative and postoperative complications. Results: The median age in our study was 58 years, with a male: female ratio of 0.57:1.The tumour was more commonly present on the left side, with pain being the most common symptom. The median size of the tumour was 7 cm. There were no intraoperative or postoperative complications. No recurrence was reported in any of the patients. Conclusion: Elastofibroma dorsi is an uncommon benign soft tissue tumour occurring in the infrascapular region of elderly patients. Typical MRI findings especially confirm benign elastofibroma. Excellent results with minimum morbidity are obtained with marginal excision. Prognosis is usually good with no recurrence.

Bilateral Elastofibroma Dorsi

1.1. Introduction: Elastofibroma dorsi (ED) is a benign, uncommon tumor, which appears in the subscapular and infrascapular region. Etiology is still under discussion. Total surgical excision is the optional treatment for symptomatic EFD. 1.2. Presentation of Case: A 48-year-old male patient presented with 2 years’ complaint of shoulder pain and paresthesia, mostly aggravated with shoulder movements and infrascapular swelling bilaterally. Both masses were totally excised with bilateral posterolateral subscapular incision. Symptoms and significant discomfort from the surgical procedure was completely resolved within a few weeks’ interval from the operation. 1.3. Discussion: it is a rare tumor, and its etiology suspected to be due to repetitive trauma and still under question, image is the best method to diagnose it. 1.4. Conclusion: EFD is a benign soft tissue tumor, placed at infrascapular region, treated with total simple excision, biopsy is not needed

Current Update on the Diagnosis, Management and Pathogenesis of Elastofibroma Dorsi.

Elastofibroma dorsi is an uncommon benign fibroblastic pseudotumor that typically occurs in the subscapular region of middle-aged or older individuals. The pathogenesis is still unclear and a matter of debate. Magnetic resonance imaging can be used as a first-line investigation of the lesion and reveals a lenticular soft-tissue mass with a signal intensity similar to that of skeletal muscle interlaced with strands of fat. Biopsy is not necessary if all pathognomonic criteria are present. A conservative "wait and see" attitude is reasonable and immediate surgery is no more the standard treatment of elastofibroma dorsi. This review provides an updated overview of the diagnosis, management and pathogenesis of elastofibroma dorsi. We also discuss recent advances in our understanding of genomic alterations in elastofibroma dorsi.

Bilateral Subscapular Masses Diagnosed as Elastofibroma Dorsi

Elastofibroma dorsi (ED) is a benign soft tissue poorly circumscribed tumor of the chest wall. ED is characterized by hyperproliferation of fibroblastic tissue. The tumor is composed of collagen and coarse enlarged elastic fibers. The pathogenesis of the lesion is multifactorial. It clinically manifests as a palpable tumor in the infrascapular or subscapular region with occasional pain and discomfort, especially during mobilization of the shoulder. We report a case of a 70-year-old manual worker male with chronic thoracic pain and palpable bilateral symmetrical dorsal subscapular masses. Magnetic resonance showed the presence of bilateral soft tissue tumors and trucut biopsy showed ED. The lesions were completely surgically excised.

Elastofibroma dorsi: clinical experiences of 19 cases

"Abstract: In this study, symptoms, functions, and outcomes of patients who underwent surgery with the diagnosis of Elastofibroma dorsi between 2007-2019 in our clinic were discussed retrospectively. A total of 19 patients were operated on with the diagnosis of Elastofibroma dorsi in our clinic. The demographic characteristics of patients such as age and gender, symptoms, clinical findings, diagnostic and radiological features, surgical procedures, results of surgical treatments, and postoperative follow-up results were evaluated based on the records. The mean age of patients who underwent surgery was 55.7 and there were 13 females and 6 males. The most common clinical complaint was swelling (61%). Seven of ED were located on the right side, 3 of them were located on the left side and 7 of ED were located bilaterally. The mass in all cases was over 5 cm in diameter, complete surgical excision was done via muscle-sparing technique. All patients were followed up postoperatively and there was no recurrence. ED should be considered in terms of differential diagnosis when middle-aged patients present with a mass in the scapular region and shoulder pain. Total excision is surgically sufficient in symptomatic patients. Keywords: elastofibroma dorsi, shoulder pain, chronic back pain"

Is it necessary to always resect elastofibroma dorsi?

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. 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. The study included 57 patients with the average age of 56.1 ± 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). 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.

Elastofibroma Dorside Ga-68 DOATATE PET-BT İle Gösterilen Somatostatin Reseptör Ekspresyonu

Elastofibroma dorsi is a rare, benign, slowly-growing connective-tissue tumor that occurs most often in the infrascapular area in elderly people. It can be detected with various imaging modalities, like CT, MRI, USG and PET. Somatostatin is an endogenous hormone known by its inhibitory and neurotransmitter effects. Ga-68 DOTATATE which is a radiolabeled somatostatin analogue may show various uptake in physiological structures and also in tumor cells. Here in this case report, we describe the receptor expression of ED and present a case whose Ga-68 DOTATATE PET-CT scan revealed bilateral infrascapular soft tissue lesions, consistent with elastofibroma dorsi. According to our knowledge, this is the second case report in the literature, showing somatostatin receptor expression in elastofibroma dorsi

Elastofibroma dorsi: What's new?

Elastofibroma dorsi is a rare slowgrowing soft tissues tumor. The lesion usually grows near the shoulder but could also involve other location. Pathogenesis of elastofibroma dorsi is still unknown and in the literature, there are mostly described case report or case series. The aim of our study is to summarize the recent innovation in the histology and immunoistochemical finding about elastofibroma and update the radiological algorithm of diagnosis.

Posterior Shoulder Pain - Baseball Pitcher

HISTORY: Patient is a 20 year old right handed college baseball pitcher with a past medical history of ulnar neuritis. He presented with a 4 month history of right-sided inferior periscapular pain after increasing his pitching speed and frequency. This pain initially occurred only with high velocity pitches but progressed to occur with all pitching and some overhead reaching activities. It was associated with a catching sensation but otherwise no mechanical shoulder symptoms or neurologic arm symptoms. He denied constitutional symptoms. PHYSICAL EXAM: General: Healthy appearing, athletic build. Inspection: No obvious asymmetry. Palpation: Non-mobile, minimally prominent mass approximately golf ball size in diameter, just inferior and medial to the inferior angle of the scapula. This was mildly tender without fluctuance. Musculoskeletal: Normal right shoulder ROM. No scapular dyskinesis. Neurologic: Normal right arm strength, sensation, and reflexes. Special Tests: Negative shoulder impingement signs. DIFFERENTIAL DIAGNOSIS: Elastofibroma dorsi Scapulothoracic bursitis Snapping scapula Lipoma Sarcoma or other tumor TESTS AND RESULTS: X-rays: Unremarkable. Ultrasound: Well-circumscribed solid soft tissue mass overlying the posterior 7th/8th ribs. MRI: 5.4 x 1 x 3.5 cm mass in the infrascapular region underlying the serratus anterior and latissimus dorsi. No rib erosion or extension into the intercostal musculature. FINAL DIAGNOSIS: Images favored a benign process. After waiting to complete the current season, the mass was excised. The mass was deep to the serratus anterior muscle and adhered to the 7th rib. Pathology demonstrated fibroblastic proliferation, likely reactive due to repetitive microtrauma. TREATMENT AND OUTCOME: No follow up imaging or additionally treatments were necessary. Six weeks after excision, patient was able to throw a baseball with no pain and return to off-season baseball training.

Surgery for elastofibroma dorsi: optimizing the management of a benign tumor-an analysis of 70 cases.

BackgroundElastofibroma dorsi (ED) is a benign soft-tissue tumor of the chest wall located near the tip of the scapula. Clinical presentation includes swelling, pain and impairment of shoulder movements. The present literature relies only on few small case series. The aim of this study was to analyze the surgical management of ED, focusing on the debated topics regarding preoperative evaluation, operative technique, post-operative outcome and follow-up.MethodsWe conducted a single-center retrospective cohort analysis of patients operated for ED between 2003 and 2018. Diagnostic techniques were ultrasonography (US), computed tomography (CT-scan) and magnetic resonance imaging (MRI). CT-scan represented our preferred imaging study for preoperative assessment. Surgery was proposed for symptomatic and/or large lesions. Marginal excision through a muscle-sparing approach was performed. An open-door follow-up policy was adopted. All clinical, radiological, perioperative and pathological variables were matched in a univariate analysis. A multivariate analysis was performed to investigate risk factors for postoperative complications. Correlations analysis between radiological and pathological measurements of elastofibroma was conducted.ResultsSeventy elastofibromas were excised in 59 patients. Mean age was 59 years and female prevalence was 59%. All elastofibromas were completely resected with no recurrence. Postoperative complications rate was 17%. Complications were mild in most cases. At the univariate analysis, patients with body mass index (BMI) >25 had a longer operative time (P=0.048), patients on antiplatelet medications experienced a prolonged drainage time (P=0.006) and a higher rate of complications (P=0.038); the occurrence of complications resulted in prolonged drainage time (P=0.047) and length of stay (P=0.023). A BMI ≤25 was the only independent risk factor for postoperative morbidity (OR 8.71, P=0.024). CT-scan showed the highest correlation with pathological size (r=0.819), US the lowest (r=0.421).ConclusionsMarginal resection through a muscle-sparing approach is safe and effective for the treatment of ED. CT-scan can be adequate for preoperative assessment. Giving the benign nature of the lesion and the absence of recurrence after complete resection, an open-door follow-up may be appropriate.

Bilateral Elastofibroma Dorsi as Differential Diagnosis in Posterior Chest Wall Tumor: A Case Report

Elastofibroma dorsi (ED) is a relatively common, albeit rarely diagnosed, benign soft tissue tumor, often with a sub- or infrascapular localization. ED is most common in females >50 years of age, and is unilateral in 67-90% of cases [1]. The pathogenesis is unclear, but it is hypothesized that repeated microtrauma stemming from friction between the scapula and the posterior thoracic wall induces an abnormal proliferation of fibroelastic tissue. Studies have also shown considerable heritability [2]. The condition is often asymptomatic, but can result in pain and decrease in upper extremity function. The diagnosis is made from MRI or pathology examination of a biopsy or tissue post excision. The present paper discusses a case of bilateral ED in a 76 year old female with a history of several years of manual labor as a hairdresser.

Prevalence of elastofibroma dorsi on CT: Is it really an uncommon entity?

ObjectiveThe aim of this study was to determine the prevalence, demographic data of elastofibroma dorsi (ED) in adult population who had undergone chest CT examination and to discuss clinical, and radiological presentations, and treatment options of ED. MethodsWe retrospectively reviewed 4074 chest CT examinations for ED from July 2014 to April 2015. Lesion size, side, and patient demographics were analyzed for positive cases of ED. The initial radiology reports of patients with ED were also reviewed. ResultsOf the 4074 patients, 111 patients (2.73%) (77 women and 34 men; mean age: 68.2 years; range: 35–91 years) had a total of 168 ED. The females had a 1.96 -fold higher prevalence of ED than the males (OR, 1.96; 95% CI, 1.481–2.59). The mean lesion thickness was found to be significantly greater in the female patients compared with the male patients (p = 0.001). The prevalence of the disease was estimated to be 4.98 times higher in patients aged 65 years or older (CI 95%, 3.25–7.36). In 111 ED patients, the lesions were only noted in 9 patients' initial radiology report. ConclusionHere, we present a prevalence study with the largest population in the literature concerning ED. Our study shows that ED is not as uncommon as previously thought and should be especially suspected in females and older age groups. Level of EvidenceLevel IV, Diagnostic Study.

Cutaneous Elastic Tissue Anomalies.

After a review of the physiology in the formation and degradation of cutaneous elastic tissue, we describe the clinicopathologic disorders characterized by increased and decreased cutaneous elastic tissue. Cutaneous disorders characterized by increased and/or abnormal elastic tissue in the dermis include elastoma, also named nevus elasticus, dermatosis lenticularis disseminata, pseudoxanthoma elasticum, late-onset focal dermal elastosis, linear focal elastosis, elastoderma, elastofibroma dorsi, and elastosis perforans serpiginosa. In some of these conditions, the specific histopathologic diagnosis may be rendered with hematoxylin-eosin stain, whereas in other ones special elastic tissue stains are necessary to demonstrate the anomalies. Cutaneous disorders characterized by decreased dermal elastic tissue include nevus anelasticus, papular elastorrhexis, perifollicular elastolysis, anetoderma cutis laxa, postinflammatory elastolysis and cutis laxa, white fibrous papulosis of the neck, pseudoxanthoma elasticum-like papillary dermal elastolysis, and mid dermal elastolysis. In most of these conditions, the histopathologic anomalies are only seen with elastic tissue stains, and cutaneous biopsies of these processes stained with hematoxylin-eosin show appearance of normal skin. The diagnosis of some of these disorders characterized by increased or decreased elastic dermal tissue should be followed by general exploration of the patient to rule out associated severe systemic anomalies, and in some cases, a genetic counseling should be offered to the family.

Elastofibroma dorsi: evaluating the sufficiency of magnetic resonance in diagnosis and the time of surgical treatment

Background: Elastofibroma dorsi is a rarely seen fibroelastic pseudotumor. While radiological evaluation can be best done with magnetic resonance imaging (MRI), biopsy may be additionally required in diagnosis. Surgical excision of the tumor is recommended in painful cases, however, many cases can be treated and followed with conservative methods. In our study, we evaluated the features and sufficiency of MRI in diagnosis, the growth extent of the masses and the need for surgical treatment.Methods: Eight lesions of the five patients diagnosed and followed up in our clinic between the years 2014 and 2017 were included in the study. All patients were female and had a mean age of 60.4 (50-68). Lesions were bilaterally located in three patients. Seven lesions were diagnosed with MRI and one was diagnosed with biopsy. The size of the lesions at the time of diagnosis and final follow-up and differences in the radiological features were evaluated by the same experienced radiologist using MRI. Complaints of the patients were evaluated, and their clinical examinations were performed.Results: The mean period of follow-up was 22.4 (8-42) months. The masses had a mean diameter of 59.5 (40-75)mm in the craniocaudal plane and 59.4 (40-70) x 22.4 (10-36)mm in the axial plane at the time of diagnosis and a mean diameter of 60.5 (40-75)mm in the craniocaudal plane and 61 (43-70) x 22.6 (10-36)mm in the axial plane at the final follow-up. At the final follow-up, two patients had three lesions without pain and three patients had five lesions with mild pain. No movement limitation was observed.Conclusions: Typical MRI findings were observed in all lesions (including the one that was performed biopsy) and biopsy was not planned for the lesions with typical findings. All lesions were followed by conservative management and no discontent was reported by the patients. Surgical treatment was planned in case of severe pain, rapid growth and advanced clinical symptoms.

Elastofibroma Dorsi: Findings on 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography.

Elastofibroma dorsi (EFD) is a relatively rare soft-tissue pseudotumor that arises from mesenchymal tissue. We present a case of 48-year-old woman who underwent 18F fluorodeoxyglucose (FDG) positron emission tomography-computed tomography for initial staging of suspected carcinoma of the left breast. Incidental detection of soft-tissue masses showing moderate FDG uptake was seen in the bilateral infrascapular location characteristic of EFD.

Elastofibroma Dorsi: Review of Literature with Radiological Approach

Elastofibroma Dorsi: Review of Literature with Radiological Approach

Preventing the development of recurrence and postoperative seroma of Elastofibroma Dorsi

Preventing the development of recurrence and postoperative seroma of Elastofibroma Dorsi

Bilateral elastofibroma dorsi - rehabilitation of an uncommon tumor

Elastofibroma are rare, slow-growing, soft tissue benign tumors that originate from mesenchymal tissue. We report an 85-year-old male patient with the diagnosis of bilateral elastofibroma dorsi whose symptoms were bilateral chronic pain in the thoracic spine and limitation of shoulder range of motion. The proposed treatment consisted of a rehabilitation program in our department mainly focused on pain management and postural reeducation of the scapulohumeral rhythm, with great improvements namely on the anterior extension and abduction of the shoulder and with no pain at the 6-month post-treatment reevaluation. This shows an important role of Physical Medicine and Rehabilitation in the management of patients with these rare tumors.

Extraordinary Presentation of Elastofibroma Dorsi After a Thoracotomy Procedure

Elastofibroma dorsi is a reactive pseudotumor of connective tissue, typically located in the infrascapular region. Awareness of this benign entity is crucial for radiologists, as well as clinicians, to avoid misdiagnosis and potential patient harm. In this report, we present clinical and imaging findings of an elastofibroma dorsi after a thoracotomy procedure.