Elastofibroma dorsi

Elastofibroma dorsi is a rare, slow-growing, and often benign soft tissue tumor that typically occurs near the lower part of the scapula (shoulder blade). This condition predominantly affects older adults, with a higher prevalence in women than in men. Elastofibroma dorsi is characterized by the proliferation of fibroelastic tissue. While its exact cause remains unclear, repetitive mechanical friction between the scapula and the chest wall is thought to play a role in its development. Most cases are asymptomatic and discovered incidentally during imaging studies for other reasons. However, when symptoms do occur, they may include shoulder pain, a feeling of mass or fullness under the shoulder blade, and limited range of motion.

Symptoms and Diagnosis

Symptoms of elastofibroma dorsi can vary but often include a soft, often painless mass on the back, under the shoulder blade. In some cases, the mass may cause discomfort or restrict movement, particularly when lifting the arm. Diagnosis typically involves a combination of physical examination and imaging studies. Magnetic resonance imaging (MRI) and computed tomography (CT) scans are particularly useful in assessing the size and extent of the tumor, as well as its relationship to surrounding structures. Biopsy may be performed to confirm the diagnosis and rule out malignancy.

Treatment

Treatment for elastofibroma dorsi is generally conservative, especially for asymptomatic cases. Observation and regular follow-ups may be recommended to monitor the tumor's growth. For symptomatic cases, or if the tumor is large and restricts movement, surgical removal may be considered. Surgery typically involves excising the mass along with a margin of healthy tissue to ensure complete removal. The prognosis after surgery is excellent, with low rates of recurrence.

Epidemiology

Elastofibroma dorsi is relatively rare, with a higher incidence reported in individuals over the age of 50. It is more common in women than in men. The exact prevalence of the condition is difficult to determine due to the high number of asymptomatic cases that may go undiagnosed.

Pathophysiology

The pathogenesis of elastofibroma dorsi is not fully understood, but it is believed to be related to mechanical stress on the shoulder girdle. Histologically, the tumor is composed of abnormal fibroelastic tissue, including elastic fibers, collagen, and myofibroblasts. The presence of degenerative changes suggests that the condition may be a reactive process rather than a true neoplasm.

Conclusion

Elastofibroma dorsi is a rare condition that typically presents as a benign soft tissue mass near the lower scapula. While often asymptomatic, it can cause discomfort and restrict movement in some individuals. Diagnosis is based on imaging studies and biopsy, with treatment options ranging from conservative management to surgical excision. Understanding of its pathophysiology remains limited, highlighting the need for further research.