CT and MRI diagnosis of elastofibroma dorsi / 实用放射学杂志

Objective To explore the CT and MRI manifestations and diagnosis of elastofibroma dorsi(EFD).Methods CT or MRI findings of 20 cases (36 lesions)of EFD confirmed by surgical pathology were analyzed retrospectively.12 patients underwent plain chest CT,4 patients plain chest MRI,4 patients plain unilateral shoulder MRI.Results ① All of cases were located in the infrascapular region,between the thorax wall and serratus anterior,mainly shaped flat mound-like or semi-circular.CT densities and MRI signal intensities of the masses were similar to those of muscle with some interlaced fat-like areas within the lesions.The masses had irregular edges, with no clear boundary between the thorax wall and serratus anterior,with disappeared fat gaps.② Statistical difference were found in patients’incidence between men and women,incidence between unilateral and bilateral and lesion volume between the left and right (P <0.05),and the incidence in female was significantly higher than that in male,the incidence in bilateral was significantly higher than that in unilateral,the lesion volume in the right was bigger than that in the left.Conclusion ① EFD has its characteristic location and imaging findings,so a definite diagnosis can be made with CT and MRI.② The mechanical friction between the scapula and chest wall may be related to tumor growth.

Imaging manifestation of elastofibroma dorsi in18F-FDG PET-CT / 中国医学装备

Objective:To explore the imaging manifestation of elastofibroma dorsi in18F-FDG PET-CT.Methods: The back soft tissue mass of abnormal metabolism was found by18F-FDG PET-CT scan, and then delayed imaging for the mass was performed.Results: Surgical pathology confirmed it was elastofibroma. The tumor showed clear boundary, there was no damage to adjacent ribs, and this method was mild radioactivity uptake, besides, metabolism was decreased at delayed imaging in18F-FDG PET-CT; the patient had no correlated clinical symptomatic and apparent positive physical signs.Conclusion: Tumor detection rate of18F-FDG PET-CT for elastofibroma dorsi is higher than normal CT detection. And the delayed manifestation for metabolism were decrease. Therefore, these situation accordance to benign tumor metabolism changes.

Elastofibroma Dorsi: Clinicopathological Analysis of 76 Cases

BACKGROUND: We aimed to investigate the epidemiological, clinical, paraclinical, and treatment aspects of elastofibroma dorsi through a retrospective study of 76 patients who underwent surgery between January 2008 and December 2012 in our department. METHODS: Our study is retrospective between January 2008 and December 2012. We admitted 79 patients with a subscapular mass, and only 76 patients had ED. The others (n=2) had high associated risk of anesthesia and were managed by a medical treatment and one patient had a subscapular sclerotic hemangioma. RESULTS: The average age of the patients was 49 years (range, 38 to 70 years), with a female predominance (54 females and 22 males). Subscapular location was constant. The right, left, and bilateral form was noted in 41, 15 and 20 cases, respectively. The diagnosis was clinical in 60 cases. Ultrasound and computerized tomography scans confirmed the diagnosis of an ill-defined mass in a subscapular location in all cases. Surgical treatment consisted of complete resection of the mass. The clinical diameter of the mass remained significantly lower than that of the surgical specimen (7 cm versus 12 cm) because the major hidden part of the mass in the subscapular area was inaccessible to palpation. Complications were noted in 9 cases (11.8%), seroma in 8 cases (10.5%), infection of wound site in 4 cases (5%), and parietal textilome in one case (1%). No case of recurrence was noted. CONCLUSION: Surgery of elastofibroma is unique because of the subscapular location of the parietal tumor, whose histological fibrous nature makes it very adherent to the chest wall.

Clinical diagnosis and treatment experience of 19-case elastofibroma dorsi / 中国综合临床

Objective To explore the experience in the diagnosis and treatment of elastofibroma dorsi.Methods Clinical data of 19 cases of pathologically confirmed elastofibroma from October 2001 to October 2011 were reviewed.The clinical features,the specific radiological characteristics,the typical pathological alterations and the short-term and long-term effects were analyzed.Results All the lesions were located within the muscles in the subscapular region.There were 3 cases with bilateral lesions and 16 cases with unilateral lesions.Seven patients complained of local pain and feeling of foreign body when activated the upper limb,while 12 were asymptomatic.Except for the early 6 cases,accurate diagnosis was made in all the other 13 cases before the histological exams solely based on the physical examination and imaging findings.Marginal excision was done for all the cases:the diameters of the masses were between 3 centimeters to 10 centimeters.Fluid accumulation complications was found in 1 case and resolved by repeated paracentesis;errhysis complication,was found in 1 case and resolved by compression,applying hemostatics and blood transfusion.No recurrence was found during the follow-up period(6 months to 48 months).Conclusion Elastofibroma dorsi is usually found in the subscapular region in elderly women.The diagnosis can be made on the basis of unique imaging characteristics and physical examination before histological examine.Surgical marginal excision can achieve good short-term and long-term effects.

Síndrome do impacto non outlet do ombro: lembrar do elastofibroma dorsi / Non outlet impingement syndrome of the shoulder: remember elastofibroma dorsi

Objetivo: Descrever cinco casos de elastofibroma dorsi (quatro unilateral e um bilateral) em pacientes que foram tratados previamente como tendinopatia do ombro. Materiais e métodos: Os pacientes referiam dor na região do trapézio, além de história, testes clínicos e exames de imagem positivos para tendinopatia do manguito rotador. Foram tratados previamente de forma não cirúrgica, por meio de medicamentos e fisioterapia, sendo encaminhados para tratamento artroscópico (descompressão subacromial e reparo do manguito rotador). Ao procurarem nosso serviço, em todos os casos se notou ao exame físico: discinesia escapulotorácica, ressalto e crepitação. Resultados: Optou-se pelo tratamento cirúrgico de forma aberta (ressecção tumoral), após diagnóstico por imagem compatível com elastofibroma dorsi. Realizou-se a ressecção da tumoração em três pacientes, pois dois recusaram o tratamento cirúrgico. Nos casos operados, o exame anatomopatológico confirmou o diagnóstico. Todos os pacientes operados obtiveram melhora do quadro de síndrome do impacto non-outlet. Conclusão: Os autores destacam que, embora rara, essa afecção deva ser considerada como diagnóstico diferencial da síndrome do impacto subacromial e salientam a importância do exame físico, em especial da articulação escapulotorácica para o correto diagnóstico desta lesão pseudotumoral.

Imaging assessment of the scapular girdle elastofibromas / Avaliação por imagem dos elastofibromas da cintura escapular

O elastofibroma dorsal, pseudotumor de partes moles com crescimento lento, tem sido cada vez mais lembrado no diagnóstico diferencial de dor escapular crônica, sendo também diagnosticado incidentalmente em exames de diagnóstico por imagem de rotina. Abordamos aqui o diagnóstico por imagem que pode começar pela radiografia convencional, mas é melhor caracterizado pelo ultrassom e pela ressonância magnética, sendo esta última a modalidade de escolha.

Elastofibroma dorsi, a slow-growing, soft-tissue pseudotumor has been more and more remembered in the differential diagnosis of chronic scapular pain. It has also been incidentally diagnosed in routine diagnostic imaging tests. Our approach here is the imaging diagnosis, which can start with the conventional X-ray, but is better characterized by the ultrasound and the magnetic resonance, the latter being the modality of choice.

Elastofibroma Dorsi in the Chest Wall: A case report / 대한흉부외과학회지

A 63 year-old woman visited our hospital with a palpable chest wall mass in the infrascapular region. We performed excision of the mass. The mass was histolocally diagnosed as elastofibroma. Elastofibroma is characterized by the proliferation of fibrous tissue with elastin. It is a relatively slow growing benign soft tissue tumor and it is most often found in the infrascapular region. We have experienced a cases of this rare disease and we report on it together with a review of the relevant literature.

Diagnosis and treatment of elastofibroma dorsi: experience in 10 cases / 中华普通外科杂志

Objective To summarize the experience in the diagnosis and treatment of elastofibroma dorsi,focusing on the clinical features,the specific radiological characteristics,and the typical pathological alterations.Methods Clinical data of 10 cases of pathologically confirmed elastofibroma dorsi from January 1997 to April 2008 were retrospectively reviewed.Results Most patients were female(8/10)in this series.All the lesions were located within the muscles in the subscapular region.There were 13 lesions in 10 cases(3 cases with bilateral involvement).Seven patients complained of pain and feeling of foreign body,and three were asymptomatic.The size of the masses was between 4 centimeters to 12 centimeters,averaging at(7.46 ±2.70)centimeters.Except for the early 3 cases,accurate diagnosis was made in all the other 7 cases before the histological exams solely based on the physical examination and imaging findings.Marginal excision was done for all the cases under general anesthesia.Fluid accumulation,as the only kind of complication was found in 3 cases which was resolved by repeated paracentesis.No recurrence was found during the follow-up period(4 months to 125 months,median 11 months).Conclusion Elastofibroma dorsi is a rare,pseudotumoral lesion usually found in elderly women.It is a very special type of soft tissue tumors that its diagnosis can usually be made solely on the basis of unique imaging characteristics and physical examination before the histological exam.Surgical marginal excision is the choice of treatment with good short-term and long-term results.

Pólipos colónicos con cambios tipo-elastofibroma: presentación de dos casos con estudio histoquímico con métodos para fibras elásticas / Presentation of two cases of colonic polyps with elastofibroma-like changes: a study with histochemical methods for elastic fibers

El elastofibroma es una neoplasia benigna de tejidos blandos, que típicamente se presenta en el tejido conectivo localizado en la región inferior de la escápula. La afección visceral es rara y su presentación como pólipos de la mucosa del colon se ha descrito solamente en dos ocasiones. Informamos dos casos de pólipos colónicos que histológicamente presentaron depósitos de un material fibrilar denso en la capa submucosa. Este material resultó ser intensamente positivo para algunas tinciones que resaltan fibras elásticas como el Verhoff, la tinción modificada de Gallego (Reyes- Mota) y el pentacrómico de Movat. Dadas las características histológicas y propiedades histoquímicas de estas lesiones, las cuales se asemejan a las del elastofibroma de tejidos blandos, se estableció el diagnóstico de pólipos colónicos con cambios ‘tipo- elastofibroma’ de la capa submucosa. Estos dos casos representan el tercer y cuarto casos informados en la literatura de esta entidad.

Elastofibroma is a tumor-like lesion of the soft tissues that is usually observed in the connective tissue of the lower portion of the scapulae. Visceral involvement is uncommon and the presentation as colonic polyps has only been described previously twice. Herein, we report two additional cases of colonic polyps with abundant submucosal deposits of a dense elastic fibrillary material which was enhanced with various elastic-fiber staining techniques, like Verhoff, modified Gallego´s stain (Reyes-Mota) and Movat´s pentachromic stain. Histological and histochemical findings of these lesions, which resembled elastofibroma of the soft tissues, established the diagnosis of colonic polyps with ‘elastofibroma-like’ submucosal change. To our knowledge, these are the third and fourth reported cases found in the literature of this uncommon entity.

Bilateral Elastofibroma Dorsi of the Shoulder: Case Report

We report a case of an 86-year-old man diagnosed with bilateral elastofibroma dorsi who was managed conservatively after a two year follow-up. An elastofibroma dorsi is a benign, slow-growing tumor that is most often located in the inferior periscapular area in elderly patients. It should be considered to differentiate them from other soft tissue tumors located at the inferior periscapular region. Increased awareness of these characteristics will decrease the incidence of a misdiagnosis of elastofibroma dorsi as a malignancy and avoid unnecessary surgery.

A Case of Elastofibroma

PURPOSE: Elastofibroma is a rare benign tumor that is characterized histologically by the presence of abnormal elastic fibers within a stroma of fibroadipose tissue. Usually it is slow-growing, solid, ill-defined mass occurring chiefly in elderly woman and arising from the soft tissue around the inferior angle of the scapula. METHODS: We experienced a representative case of elastofibroma. A 73-year-old women complained of a soft-tissue mass, which measured 6x6cm, at the inferior angle of the left scapula, which had been found incidentally 4 months before. When the arm was elevated, the mass projected out beneath the scapula. The entire mass was resected with a tumor-free margin. RESULTS: The resected tumor appeared to be nonencapsulated, fibrous and white mass, and it contained yellow fatty streaks. We confirmed that the histopathologic diagnosis of this tumor was elastofibroma. Follow- up examination revealed no evidence of local recurrence for 10 months. CONCLUSION: This entity is rarely reported in Korea. However, more patients could be diagnosed if physicians pay more careful attention to clinical and radiological features of elastofibroma. Moreover, recognizing the benign nature of this lesion is important to avoid an unnecessary operation.

Elastofibroma

An elastofibroma, which is a rare soft tissue tumor, was excised from the left subscapular region of a 82-year-old woman. An elastofibroma is a slow-growing, pseudotumoral lesion of the soft tissues of the chest wall with peculiar radiological (CT, MR) and ultrasonographic images, and histological patterns. All cases need to undergo a biopsy in order to rule out a sarcoma. An elastofibroma is a benign tumor. If left untreated, it can grow to a considerable size and become symptomatic. Therefore it needs to be closely observed and its nature confirmed by a biopsy. This condition is rarely encountered in Korea. However, more patients could be diagnosed if more careful attention to elastofibroma is paid.

A Case of Elastofibroma / 대한피부과학회지

Elastofibroma is a rare disease which presents as a slowly-growing, solid, ill-defined fibroelastic mass occuring almost exclusively in elderly women and arising mainly from the connective tissue between the lower part of the scapula and chest wall. Of the 270 cases of elastofibroma which have been reported, 170 cases had developed in Japanese patients. Despite the fact that there have been only two case reports in Korea, there might be a higher prevalence of elastofibroma in Korea than expected because of geographical similarity. We experienced a case of elastofibroma occurring in a 56-year-old man. To our knowledge, this is the first case report of elastofibroma in Korean dermatologic of literature.

Bilateral Elastofibroma: Report of a case

Elastofibroma is a rare benign tumor-like condition manifesting as firm and spherical mass with poorly circumscribed margins of fibroelastic tissue, occuring in the subscapular region or the chest wall of elderly persons. It is not a true neoplasm but rather a reactive or degenerative process causing abnormal elastogenesis. It is unilateral in the majority of cases and the right side is affected more commonly than the left. We report a case of bilateral elastofibromas removed from both subscapular regions of a 73-year-old female farmer. She was presented with tender masses on the bilateral subscapular areas for seven years. Microscopically, it consisted of a mixture of intertwining broad eosinophilic collagen bundles and elastic fibers associated with a few fibroblasts and mature fat cells. The elastic fibers had a degenerated beaded appearance or were fragmented into serrated globules in a linear arrangement.

Elastofibroma: Report of a case

Elastofibroma is a rare entity of slowly-growing, solid, ill-defined fibroblastic mass occurring almost exclusively in elderly persons and arising mainly from the connective tissue between the lower portion of the scapula and the chest wall. This entity has been considered to be a degenerative pseudo-neoplastic process caused by mechanical friction. We report an additional case of elastofibroma removed from the subscapular region of a 58-year-old woman. Microscopically the tumor was made up of a mixture of swollen eosinophilic collagen and elastic fibers occasionally associated with fibroblasts and mature fat cells. The elastic fibers showed a degenerated beaded appearance or were fragmented into small globules or droplets in a linear pattern.

Elastofibroma

Elastofibroma is a rare benign tumorous growth presenting as a slowly growing ill-defined mass of fibroblastic tissue occurring in elderly persons and arising mainly form the connective tissue between the lower portion of the scapula and the chest wall. Its pathogenesis is not well established but it may be the result of nonneoplastic reactive hyperplasia taking place with constitutional predisposition in the background. A case of elastofibroma occurring in the subscapular area of a 65-year-old female cook is presented. The mass, 6x5x3 cm in maximum dimensions, was poorly circumscribed, solid, hard, pale fleshy and pray-white fibrous tumor. Microscopically, it was composed of numerous small globular and linear elastic fibers embedded in collagenous matrix. To our knowledge, it is the first case of elastofibroma in Korea.