Presentation
Chest pain and pain when using left shoulder. The physical examination demonstrated a well-circumscribed, mobile mass under the inferomedial angle of the left scapula.
Patient Data
Chest CT without and with contrast.
Posteriorly and bilaterally in the suprascapular region, in an atypical position, there is a soft tissue mass deep in the muscles and adjacent to the chest wall. The masses contain alternating soft tissue and fat density components with moderate enhancement compatible with elastofibroma dorsi. Also on both sides, two small masses are visible in the subscapular area, larger on the left, with CT characteristics identical to those of the suprascapular lesions.
Chest MRI.
MR images demonstrate bilateral and posteriorly a fairly well-circumscribed fibrofatty mass interposed between the upper scapula and chest wall, with enhancement after contrast, consistent with an elastofibroma dorsi. Again on both sides, the two small elastofibromas are confirmed in the subscapular area, the largest on the left.
Case Discussion
Elastofibroma dorsi is usually unilateral but can be bilateral and multiple and has an increased T1 signal as do lesions that contain fat or hemorrhage.
Case courtesy Dr.ssa Laura Braccaioli
Radiographer: TSRM Fabio Imola
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