Elastofibroma dorsi

Case contributed by Ahmad Amer
Diagnosis almost certain

Presentation

Patient with a history of diabetes mellitus presented with a painful mass on her right thorax with associated right neck, arm, and leg pain.

Patient Data

Age: 35 years
Gender: Female
ct

Soft tissue mass lesions with internal fatty streaks are seen within the infrascapular regions deep to the serratus anterior and latissimus dorsi muscles bilaterally. Findings are most consistent with bilateral elastofibroma dorsi, right side bigger than the left.

Case Discussion

Our patient presented with a painful mass on her right thorax with associated right neck, arm, and leg pain. She noted the marble-like mass on her right side overlying her latissimus dorsi three months ago. Since that time, it has progressively grown and become painful. She describes the pain as muscular and worse with movement, rating it a 10/10 with decreased range of motion of her shoulder. Over the last few weeks, she has also noted the pain radiating to her neck, mid back, and down her arm and leg. She notes two weeks of general fatigue.

On CT evaluation, our patient presented with tissue mass lesions with internal fatty streaks within the infrascapular regions deep to the serratus anterior and latissimus dorsi muscles bilaterally, classic for elastofibroma dorsi. In terms of management, the presence of swelling and pain typically makes patients prefer surgical excision. Our patient is currently awaiting evaluation by the surgical oncology team who have determined the case to be non-emergent.

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