Elastofibroma dorsi: diagnostic and therapeutic algorithm

J Shoulder Elbow Surg. 2012 Jan;21(1):77-81. doi: 10.1016/j.jse.2011.01.043. Epub 2011 Apr 27.

Abstract

Background: Elastofibroma typically occurs in the subscapular region of elderly individuals and has a high incidence in Kyushu and the surrounding islands in southern Japan. The treatment of this lesion is somewhat controversial.

Patients and methods: Eleven patients with a diagnosis of elastofibroma dorsi were identified from the unit's database. The clinical presentation, diagnosis, and treatment options were evaluated.

Results: There were 6 men and 5 women, with a mean age of 66.7 years (range, 49-82 years). Bilateral lesions were found in 2 patients. The mean lesion size was 6.6 cm in greatest dimension (range, 5-9 cm). The mean follow-up of both surgically and conservatively managed patients was 16.4 months (range, 2-69 months). All were diagnosed by magnetic resonance imaging, and early in the series, 1 also underwent an open biopsy to confirm the diagnosis. Five patients underwent marginal excision of the lesion. No recurrence was observed at last follow-up.

Conclusions: Magnetic resonance imaging can be used as a first-line investigation of the lesion, and biopsy is not necessary in most cases. We suggest that a conservative "wait-and-watch" attitude is reasonable and may be considered even when patients are symptomatic.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms*
  • Biopsy
  • Diagnosis, Differential
  • Female
  • Fibroma / diagnosis*
  • Fibroma / surgery
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Scapula*
  • Soft Tissue Neoplasms / diagnosis*
  • Soft Tissue Neoplasms / surgery
  • Tomography, X-Ray Computed