Elastofibroma Clinical Presentation

Updated: Apr 05, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Elastofibroma dorsi is an uncommon benign soft tissue pseudotumor usually located at the lower pole of the scapula, deep to the serratus anterior, and often attached to the periosteum of the ribs; patients with elastofibroma dorsi present with a long history of swelling and, occasionally, pain and discomfort. [13] Sometimes, the swelling produces an elastofibroma as an unexpected finding in those unfamiliar with this entity. [1] As it is often bilateral, the contralateral site should be evaluated. [15] Half the patients in one series of 71 patients described a clunking sensation or a localized scapular swelling during movement. [16] It can be an uncommon cause of chest pain. [17]

This uncommon fibrous pseudotumor has also been described on the foot, hand, thigh, olecranon, GI tract, trachea, dorsal spine, eye, and soft palate. [18]

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Physical Examination

Clinically, patients with elastofibromas usually present with a large, well-circumscribed tumor that most often does not adhere to the overlying skin. One case of ulceration has been described. [19] In 99% of cases, elastofibromas are located in the periscapular area, in relation to the latissimus dorsi, rhomboid, and serratus anterior muscles. [20] It may be bilateral. [21] Although usually asymptomatic, it may be associated with mild pain when moving the scapula.

Uncommon locations include the deltoid muscle, [22] ischial tuberosity, greater trochanter, olecranon, thoracic wall, foot, stomach, mediastinum, [23] orbita, cornea, and oral mucosa. [24] Occasionally, the tumor invades the surrounding tissues and becomes fixed to the underlying periosteum. Usually, the lesions are prominent and measure several centimeters in length; however, a small elastofibroma may be overlooked unless the patient is asked to move his or her arm laterally or anteriorly. Most patients with elastofibromas are asymptomatic. Only rarely do they report stiff shoulders, local pain with arm movement, and/or an annoying click with shoulder motion occur. [25] Potter et al reported an elastofibroma presenting in the oral cavity [26] ; Hsu et al described a case of elastofibroma oculi. [27]

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