Elastofibroma Dorsi: Diagnosis and Management in Soft Tissue Tumors

Elastofibroma dorsi is a benign, slow-growing soft tissue lesion typically located in the infrascapular region, deep to the serratus anterior and latissimus dorsi muscles. Its pathogenesis is thought to involve repetitive microtrauma and reactive proliferation of fibroelastic tissue, leading to the characteristic admixture of collagenous strands and fragmented elastic fibres. Clinically, patients often present after the fifth decade of life with swelling, discomfort or snapping sensations of the scapula. Imaging with magnetic resonance and computed tomography usually reveals a poorly defined mass of alternating fatty and fibrous components, which can mimic malignancy. Histopathological examination remains the gold standard for definitive diagnosis, demonstrating expanded elastic fibres on special staining. Management is dictated by symptoms: asymptomatic lesions are observed without intervention, while marginal excision is reserved for those with pain or functional impairment. Surgical resection is typically curative, with low recurrence rates but potential for postoperative seroma or haematoma if drains and compression are not employed. Recent advances emphasise refined imaging criteria to distinguish elastofibroma from neoplastic conditions, minimal-invasive biopsy techniques for preoperative confirmation and risk–benefit assessment tools to guide patient-centred decision-making. Improved awareness of elastofibroma dorsi globally can prevent misdiagnosis, reduce unnecessary radical surgery and facilitate prompt treatment of symptomatic cases.

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Elastofibroma Dorsi: Diagnosis and Management in Soft Tissue Tumors publication trend

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Technical terms

Pseudotumour: A non-neoplastic mass lesion that mimics a true tumour in clinical and imaging appearance.

Infrascapular region: The anatomical space beneath the scapula, bordered by the serratus anterior and latissimus dorsi muscles.

Marginal excision: Surgical removal of a lesion with a thin margin of normal tissue, preserving surrounding structures.

Histopathology: Microscopic examination of tissue to identify cellular and structural characteristics essential for diagnosis.

References

1. Subscapular elastofibrolipoma treated with marginal resection: two case reports. Journal of Medical Case Reports (2022).
2. Elastofibroma Dorsi Detected Incidentally on Chest Computed Tomography: The Prevalence and Reporting Rate in Radiology Reports. Cureus (2023).
3. Management of Symptomatic Elastofibroma Dorsi: A Case Report and Literature Review. Cureus (2022).