Elastofibroma dorsi

Elastofibroma dorsi is a benign soft-tissue tumour with a characteristic location and imaging appearance.

It is more frequently seen in older women, with a reported female predilection of 5-13:1. The estimated mean age at diagnosis around 65-70 years.

Elastofibroma dorsi is classically located in the infrascapular regions, deep to the serratus anterior and latissimus dorsi musculature. Unilateral masses have a slight right-sided predilection, but up to 60% of elastofibromas are bilateral.

In many cases patients are asymptomatic. Up to 50% of patients describe localised symptoms including:

  • pain especially on movement
  • sensation of clicking, snapping, or clunking of the scapula

Elastofibroma dorsi is composed of fibrous tissue with internal fatty streaks, which accounts for its imaging appearance. 

Ultrasound

Ultrasound demonstrates well-defined multi-layered pattern of hypoechoic linear areas of fat deposition intermixed with echogenic fibroelastic tissue.

CT

These masses typically appear as poorly defined soft-tissue mass with attenuation similar to that of the adjacent skeletal muscle. They are located in the infrascapular or subscapular region with attenuation similar to that of the adjacent skeletal muscle.

MRI

MRI appearance matches that of the underlying pathology. The mass appears as alternating fibrous and fatty components. 

Although the borders of these masses are relatively well defined, no capsule can be identified. 

  • T1
    • fibrous component: isointense to muscle
    • fatty component: high signal
  • T2
    • fibrous component: isointense to muscle
    • fatty component: high signal
  • T1 C+ (Gd): heterogeneous low level enhancement
PET/CT

Elastofibroma dorsi frequently show mild to moderate FDG uptake, which should not be misinterpreted as malignant lesion 5.

It was first described by O H Jarvi and A E Saxon in 1959 3.

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Article information

rID: 12565
Section: Pathology
Synonyms or Alternate Spellings:

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