Figure 1
Teaching Case
SectionMusculoskeletal system
Case TypeClinical Cases
AuthorsIannaccone R, Votta V, Roselli A, Di Rezze L, Sedati P
Connected authors
49 years, female
The patient presented with a history of right lower shoulder swelling which had increased gradually over the previous two years. Physical examination showed a mass of soft consistency without tenderness or muscle weakness.
Elastofibroma dorsi
The patient presented with a history of right lower shoulder swelling which had increased gradually over the previous two years.
Physical examination showed a mass of soft consistency without tenderness or muscle weakness.
CT and MRI were subsequently performed. CT imaging showed a heterogeneous large mass with irregular shape and margins, located in the posterior chest wall, mild enhancement after contrast material administration and no calcifications. MRI showed a large mass with fibrous content and partial fat suppression.
Surgical excision was perfomed and a soft, uncapsulated mass was found. On histological examination, the lesion was proved to be elastofibroma dorsi.
Physical examination showed a mass of soft consistency without tenderness or muscle weakness.
CT and MRI were subsequently performed. CT imaging showed a heterogeneous large mass with irregular shape and margins, located in the posterior chest wall, mild enhancement after contrast material administration and no calcifications. MRI showed a large mass with fibrous content and partial fat suppression.
Surgical excision was perfomed and a soft, uncapsulated mass was found. On histological examination, the lesion was proved to be elastofibroma dorsi.
Elastofibroma is a benign tumour-like lesion of soft tissue which may develop as a reaction process to mechanical friction. The most common age of appearance is over 55 years with an incidence of 24% in women and 11% in men and with a male-female ratio of 1:2. The posterior chest wall and the inferior margin of the scapula are the most frequent locations. The lesion is bilateral in 15% of cases.
Diagnosis is usually made on the basis of CT or MR images. On CT images, elastofibroma appears as a heterogeneous, poorly defined lesion of soft tissue attenuation similar to muscle. On MR images, elastofibroma is usually disclosed as a well-defined lesion of intermediate-signal intensity with interlaced areas of fat-intensity signal on T1- and T2-weighted images.
Histology of elastofibroma shows enlarged irregular serrated elastic hypereosinophilic fibres, collagen, scattered fibroblasts and occasional lobules of adipose tissue.
With regard to the clinical picture, the lesion is usually asymptomatic and may remain clinically inapparent. Sometimes, however, clinical symptoms, such as snapping scapula or shoulder pain, may be present.
Elastofibroma should be considered in the differential diagnosis of tumours deeply located within the periscapular area.
Diagnosis is usually made on the basis of CT or MR images. On CT images, elastofibroma appears as a heterogeneous, poorly defined lesion of soft tissue attenuation similar to muscle. On MR images, elastofibroma is usually disclosed as a well-defined lesion of intermediate-signal intensity with interlaced areas of fat-intensity signal on T1- and T2-weighted images.
Histology of elastofibroma shows enlarged irregular serrated elastic hypereosinophilic fibres, collagen, scattered fibroblasts and occasional lobules of adipose tissue.
With regard to the clinical picture, the lesion is usually asymptomatic and may remain clinically inapparent. Sometimes, however, clinical symptoms, such as snapping scapula or shoulder pain, may be present.
Elastofibroma should be considered in the differential diagnosis of tumours deeply located within the periscapular area.
References
[1]
Zelger B.
Connective tissue tumors.
Recent Results Cancer Res. 2002;160:343-50. (PMID: 12079232)
[2]
Bae SJ, Shin MJ, Kim SM, Cho KJ.
Intra-articular elastofibroma of the shoulder joint.
Skeletal Radiol. 2002 Mar;31(3):171-4. (PMID: 11935203)
[3]
Zissin R, Shapiro-Feinberg M.
Elastofibroma dorsi: CT appearance.
Isr Med Assoc J. 2001 Oct;3(10):780. (PMID: 11692559)
[4]
Abe S, Miyata N, Yamamoto Y, Yamaguchi T, Tamakawa M.
Elastofibroma dorsi: CT, MRI, and pathologic findings.
Plast Reconstr Surg. 1999 Dec;104(7):2121-6. (PMID: 11149778)
Case information
| URL: | https://www.eurorad.org/case/2518 |
| DOI: | 10.1594/EURORAD/CASE.2518 |
| ISSN: | 1563-4086 |
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