Elastofibroma dorsi

Isolated Elastofibroma of the Thigh: A Case Report

A 55-year-old female presented with elastofibroma of the thigh. On presentation, she complained of a palpable, painful mass on the anterolateral right thigh that had been present for one year. She had a history of surgery for a right femur fracture. On MRI, a soft-tissue mass was seen in the vastus intermedius muscle, as a heterogeneous lesion with streaky fatty and fibrous components. The fibrous component was isointense to the muscle, and the fatty component had a high signal on both T1- and T2-weighted images. Histopathological analysis after biopsy established the diagnosis of elastofibroma.

Subscapular elastofibrolipoma treated with marginal resection: two case reports

Background

Elastofibroma dorsi is a rare benign tumor of soft tissue, typically under the lower angle of the scapula. Its specific location and distinctive clinical symptoms can provide enough information for diagnosis. Nevertheless, pathological confirmation by biopsy may be needed to rule out other malignancies.

Case presentation

Here, we present two cases of 63-year-old and 49-year-old female Asian patients who came to us with the chief complaint of pain and bulging in their shoulders. Both patients had rubbery and mobile masses. Also, shoulder movements were not restricted in the examination; however, the patients expressed pain during movements. Computed tomography scans were compatible with the diagnosis of elastofibroma dorsi. Surgical excision was performed for both cases owing to the symptomatic nature of the masses, and histopathological findings confirmed the diagnosis.

Conclusion

Elastofibroma dorsi is a benign pseudotumor presenting with an uncomfortable feeling in the shoulder with movement in older females. In typical symptom-free cases of elastofibroma dorsi, observation is sufficient, while in symptomatic patients or if there is suspicion of malignancy, complete resection with marginal resection is the treatment of choice.

Elastofibroma Dorsi, a Rare Condition, with Challenging Diagnosis. Case Report and Literature Review

Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a case of a bilateral elastofibroma dorsi (ED) in a 65-year-old female who presented to the Department of General and Oncologic Surgery of Emergency Clinical Municipal Hospital Timisoara, Romania. The patient was symptomatic on the right side, presenting pain in the interscapulothoracic region associated with a variable tumoral mass, dependent on the position of the right arm. Imaging studies revealed a well-defined, bilateral tumoral mass with alternation of the muscular and fatty tissue. The initial diagnosis of lipoma was taken into consideration based on the CT scan and clinical findings. Surgical excision of the right subscapular tumor was performed without any postoperative complications. Microscopic examination of hematoxylin and eosin, Masson’s trichrome, and orcein stained slides revealed the diagnosis of ED. Considering the high rate of reported postoperative complications and the asymptomatic presentation of the contralateral subscapular mass, the patient underwent clinical and imagistic monitoring for the contralateral tumor. Due to its rare nature, ED is a difficult preoperative diagnosis that can, however, be suggested by its specific location and may require an accurate histopathological examination for a final diagnosis.

Diffusion MR: A New Diagnostic Tool for Elastofibroma Dorsi

Elastofibroma dorsi is a benign lesion commonly presents as a palpable enlarging mass at the inferior pole of the scapula. Clinical presentation and radiological characteristics are often enough to suggest an accurate diagnosis. Increased awareness of the characteristic appearance and location of these benign lesions will increase radiologic diagnosis and decrease the need for biopsy.

Ten patients were admitted with a complaint of asymptomatic or painful subcutaneous masses localized at subscapulary region. Thorax computed tomography, magnetic resonance imaging (MRI) and a new feasible technique in differential diagnosis with malignancy and probable diagnosis of elastofibroma dorsi and diffusion-weighted MRI were used for diagnosis.

Surgery was applied to all patients, frozen-section biopsies of the lesions at the preoperative period, and final pathologies were all benign. Totally resection of whole lesions as en-bloc excision without any rest was performed at all patients. Postoperative and follow-up periods were uneventful.

Diffusion MRI can play an important role in the future and save the patients, especially medically poor ones, from the potential risks of surgery. Necessary further examinations for probable bilaterally lesions will save the patient from the risk of a second operation.

Concomitant bilateral elastofibroma in the infrascapular and gluteal regions: a report of a rare case

BACKGROUND

Elastofibroma is a benign soft tissue tumor characterized by the presence of elastic fibers in a stroma of collagen and mature adipose tissue. It is reported to have a prevalence of 2.73%, as shown by a study through computed tomography (CT) images. However, multiple elastofibromas are uncommon.

CASE PRESENTATION

We report a case of concomitant bilateral elastofibroma in the infrascapular and gluteal regions. A 63-year-old male patient presented with a 6-month history of gradually increasing painless swellings in the upper back. On physical examination, firm, painless bilateral infrascapular masses were identified; these masses were more noticeable on forward arm flexion. Contrast-enhanced computed tomography showed well-defined bilateral infrascapular masses deep to the serratus anterior muscles as well as poorly defined bilateral gluteal masses with attenuation similar to that of the adjacent skeletal muscle. Magnetic resonance imaging revealed heterogenous masses with internal fatty streaks, consistent with elastofibroma. The histopathological diagnosis of elastofibroma was established based on the results of image-guided core-needle biopsy. The patient underwent surgical excision of both infrascapular elastofibromas with no post-operative complications. As the gluteal masses were incidental, surgical management was not warranted.

CONCLUSION

The presence of multiple elastofibromas is unusual. This report describes a rare case of multiple elastofibromas and its typical imaging features, and alerts us that elastofibromas are not exclusive to the periscapular region.

Bilateral and atypical localized elastofibroma dorsi in a patient with shoulder and back pain: A case report

A 61-year-old woman presented with localized back pain at the left inferomedial border of the scapula and left shoulder pain. On physical examination, a soft tissue mass was detected on the left scapula. Magnetic resonance imaging showed a mass at the left suprascapular region and another mass in the left infrascapular region. A Tru-Cut biopsy of the lesion at the left suprascapular region was obtained due to atypical localization. Pathological examination was consistent with an elastofibroma. During wire-marking, another mass was detected at the right infrascapular region. Three mass lesions were excised on consecutive operations. During follow-up, the patient reported reduced shoulder and back pain.

Elasto fibroma Dorsi: a case report of bilateral tumours and excision of the symptomatic lesion in a male patient

Elasto fibroma dorsi is a rare tumour of the shoulder girdle that usually arises at the infra scapular area. We present a 57-year-old male with a soft tissue swelling on his right infra scapular area of 6 months duration. It was a painless lesion which caused him discomfort while sleeping. Preoperative imaging revealed bilateral tumours but the left tumour was impalpable. The surgery itself was uneventful but post-operatively he developed a haematoma which was managed conservatively Elasto fibroma is a benign pseudo tumour of the shoulder girdle. It’s aetiology is tied in to repetitive trauma of the shoulder girdle resulting in a pseudo tumour at the infra scapular area. Magnetic resonance imaging is the diagnostic modality of choice and is pathognomic in the presence of bilateral infra scapular tumours. Treatment is usually conservative and tissue diagnosis is essential as it can mimic a soft tissue sarcoma radiologically.

Advanced Imaging of the Scapula: What Every Radiologist Needs to Know

The scapula plays a central role in shoulder motion and stability. A wide variety of anatomic variants as well as traumatic, neoplastic, and infectious pathologies can involve the scapula. Detection of scapular lesions using radiography can be challenging because of the obscuration by the overlying structures or incomplete imaging during shoulder magnetic resonance imaging or computed tomography examinations. Familiarity with imaging characteristics of these abnormalities will allow radiologists to better diagnose and characterize scapular disorders.

Unusual Presentation of Elastofibroma Dorsi on 18F-FDG-PET/CT: A Case Report

A 70-year-old male patient underwent an Fluorodeoxyglucose-positron emission tomography-computed tomography for staging of a left parahilar lung neoplasm found during work-up for fatigue and asthenia. The scan demonstrated a hypermetabolic lung tumor, a hypermetabolic pleural effusion and 4 hypermetabolic bilateral soft tissue lesions of the chest wall corresponding to 4 elastofibroma dorsi. Initially, the oncologic disease was classified as stage IV because of the hypermetabolic pleural effusion. A transbronchial biopsy showed squamous cell carcinoma and the cytology of the pleural effusion revealed no malignant cells. As the other 4 hypermetabolic thoracic wall lesions were correctly diagnosed as benign despite their unusual presentation, the patient underwent surgery by left pneumonectomy and mediastinal lymphadenectomy. The lymph node involvement required adjuvant chemotherapy. Diagnostic confidence of the benignity of the hypermetabolic chest wall lesions allowed a more aggressive treatment with a better outcome after a malignant pleural effusion was excluded.

The comparison of measurement accuracy among three different imaging modalities in evaluating elastofibroma dorsi. An analysis of 52 cases

PURPOSE

Elastofibroma dorsi (ED) is a rare soft-tissue tumour. Diagnosis is made using imaging, mainly magnetic resonance due to its higher sensitivity and specificity in soft tissues. No agreement exists when deciding which imaging test must be used. Often multiple tests are made in the same patient, increasing time and costs. The aim of this paper is to compare the usual imaging exams and evaluate which one is the most accurate when diagnosing and measuring ED.

METHODS

A retrospective review was made of those patients who were diagnosed and operated for ED since January 2006 to December 2013. Fifty-two ED were included (19 men, 25 women), and eight of them were bilaterally affected. They were divided into three different groups according to the imaging test used: ultrasound (US) computed tomography (CT) and magnetic resonance (MR). After surgery the pieces were sized and compared with the measurements made by imaging exams.

RESULTS

Two hundred fourteen measures were analysed (40 US, 33 CT and 34 MR with their pathological equivalent). When CT group and its corresponding AP were analysed, no significant differences between them were founded (p > 0.05). Moreover, we analysed absolute differences between measures. In the US group a mean difference of 2.23 ± 1.87 cm was obtained. In the CT group, the mean difference was 1.22 ± 0.97 cm. Likewise, the difference of the MR group was 1.62 ± 1.15 cm.

CONCLUSIONS

This study demonstrates that the CT obtains a higher correlation than MR when determining the size of ED.

Bilateral elastofibroma dorsi: A case report

INTRODUCTION

Elastofibroma dorsi(EFD) is slow-growing, benign, soft tissue tumor of unclear pathogenesis, typically located at the subscapular region of elderly people. It may be unilateral or bilateral. As it exhibits benign behavior, it should be surgically removed only in symptomatic patients. Magnetic resonance imaging (MRI) is a useful tool for assessment of EFD and can potentially help avoid the need for unnecessary biopsy and surgery.

PRESENTATION OF CASE

A 62-year-old woman presented with 2 years complaint of back pain, particularly aggravated with shoulder movements and swelling with bilateral elastofibroma dorsi. Both masses were totally excised with bilateral posterolateral subscapular incision. Symptoms were completely controlled and significant discomfort from the surgical procedure was completely resolved with in a few weeks interval from the operation.

DISCUSSION

The pathogenesis of the EFD still remains unclear. Elastofibroma dorsi has an unspecific clinical presentation and can be confused with other tumors of the periscapular region Imaging studies are useful for diagnosis.

CONCLUSION

Elastofibroma dorsi is benign soft tissue tumor mostly observed in the subscapular regions of elderly female patients. The surgery is indicated in symptomatic cases and must be confined to simple excision of the lesion.

Triple locations of elastofibroma dorsi: First case report and review

INTRODUCTION

Elastofibroma is a rare benign fibroelastic tumor.

CASE

We report a case of a 44-year-old woman, operated 4 months ago for a left infrascapular desmoid tumor and presented for bilateral mass of the left suprascapular and right infrascapular regions which were surgically resected. The diagnosis of elastofibroma was made and also confirmed for the left infrascapular desmoid tumor. Six months later, she presented an asymptomatic left infrascapular recurrence. Monitoring was continued and the patient is still asymptomatic after 24 months.

DISCUSSION

We highlight the importance of imaging features understanding in order to avoid misdiagnosis and unnecessary surgical resection.

Elastofibroma dorsi management and outcomes: review of 16 cases

OBJECTIVES

Elastofibroma dorsi (ED) is a rare, benign lesion arising from connective tissue, usually found at the inferior pole of the scapula. To date, only a few small series have been reported in the English literature and there are few data about the long-term outcomes after surgery. Our goal is to contribute a better understanding of this tumour and to determine the long-term outcomes after surgery.

METHODS

Sixteen patients with a diagnosis of ED were identified from the unit's database. The clinical presentation, diagnosis, pathological evidences and long-term outcomes were evaluated.

RESULTS

There were 11 females and 5 males with a mean age of 61.1 years (range 38-78 years). The tumour was located on the right in 5 (31.2%) patients, on the left in 6 (37.5%) patients and bilaterally in 5 (31.2%). Six patients had painful scapular swelling resulting in restriction of movement of the shoulder whereas 10 reported only painful scapular mass. All 16 patients underwent complete resections. The tumour size ranged from 3 to 15 cm. The mean hospital stay was 3.1 ± 1.4 days with a morbidity of 18.75% (seroma observed in 3 patients). The mean follow-up was 58.4 ± 29.5 months (range 11-92 months). In 2 patients (12.5%) a new occurrence on the contralateral side was observed at the follow-up.

CONCLUSIONS

Elastofibroma dorsi is a rare, ill-defined, pseudotumoural lesion of the soft tissues. Surgical treatment can be proposed if the lesion is symptomatic. Furthermore, at the follow-up, the possibility of new occurrences on the contralateral side should be kept in mind.

Elastic fibers in elastofibroma dorsi by fine-needle aspiration

Fine-needle aspiration (FNA) features of elastofibroma dorsi (EFD) in a 56-year-old woman were evaluated. The patient presented with 5 cm soft tissue mass located between the inferior part of scapula and the chest wall. FNA smears were hypercellular, characterized by a mixture of uniform spindle cells, mature adipocytes, and collagen tissue fragments in varying proportions. The cytological findings included abundant degenerated elastic fibers presented as linear ("braid-like") and globular bodies with shell-like and stellate appearances with serrate borders, permitting a diagnosis of EFD. Occurrence of degenerated elastic fibers in FNA smears of elastofibroma is a highly diagnostic sign in the typical clinical setting and eliminates the need for preoperative histological examination.

Elastofibroma dorsi: case series of a rare benign tumour of the back

We analyse this rare pseudotumour with few case reports in the orthopaedic literature. Elastofibroma dorsi is an uncommon benign soft tissue pseudotumour usually located at the lower pole of the scapula. This study is a clinical assessment of 5 patients. All the patients had their diagnosis based on clinical and MRI findings and had excision biopsy. The patients were followed for a mean period of 24 months. No patient had residual symptoms. We have only one recurrence. Surgical excision is recommended when it causes functional disability, compression symptoms, an asymmetric outline of the chest wall, or when it is more than 5 cm in diameter. Pre-operative tissue diagnosis is not necessary in most cases. Despite its rarity, the elastofibroma dorsi should always be suspected with the emergence of a swelling in the subscapularis, especially in females and in old age.

[Dorsi elastofibroma. About 14 cases, and review of the literature]

Elastofibroma dorsi is a benign tumor which usually occurs at the inferior angle of the scapula. We retrospectively reviewed 14 cases of elastofibroma dorsi, in nine patients. The patients were hospitalized in the departments of plastic surgery, orthopedic surgery or visceral surgery. Mean age was 67 years. The location of the lesions (bilateral in five patients) was typical, in the thoracoscapular region. Nine lesions were removed surgically, six shoulders were asymptomatic after surgery. Elastofibroma is a rare, slow-growing lesion. It occurs in connective tissue of the infrascapular region of elderly patients. The pathogenesis of the lesion still remains unclear. MRI and computed tomography are useful for assessment of elastofibroma dorsi, and can potentially help avoid the need for unnecessary biopsy and surgery, especially in the asymptomatic patient. It should be surgically removed only in symptomatic patients.

Elastofibroma dorsi: an uncommon benign pseudotumour

Elastofibroma dorsi is an uncommon benign soft tissue pseudotumour usually located at the lower pole of the scapula, deep to serratus anterior, and often attached to the periosteum of the ribs, presenting with long history of swelling and occasionally pain and discomfort. This lesion is usually seen in patients over the age of 50 years and is not uncommonly mistaken as a malignant tumour because of its size and location deep to the periscapular muscles. Review of the orthopaedic oncology database of 17 500 patients revealed that there were 15 patients with elastofibroma dorsi. There were 12 males and 3 females, mean age at diagnosis of 68.4 years range 51–79 years. The diagnosis was confirmed by MRI in 3 patients, excision biopsy in 3 patients, trucut biopsy in 8 patients and open biopsy in 1 patient. Eight patients had excision of the lesion which was symptomatic. There have been no recurrences. We highlight the clinical and radiological presentation of elastofibroma dorsi to increase awareness of its existence and management.

Elastofibroma dorsi: A soft tissue masquerade

Elastofibroma dorsi (ED) is a soft tissue tumor found in the subscapular region. The pathogenesis of ED is unclear, but may involve a regenerative or reactive hyperproliferation due to mechanical microtrauma. Magnetic resonance imaging (MRI) is preferred to diagnose ED and complete excision is curative. When bilateral, subscapular masses are identified in the elderly patient and MRI characteristics are typical, biopsy and excision can be avoided. Symptomatic EDs should be excised, and recurrence is rare. Three hundred and thirty cases of ED have been reported since 1980. Fourteen case series and 43 isolated case reports involved 263 women and 67 men (F:M ratio = 3.9:1), with a mean age of 62 years (range 6–94 years). Bilateral ED was present in 164 patients and unilateral ED in 157. The reported prevalence in the elderly population ranges from a minimum of 2% to a maximum of 24%.

Characterization of Elastofibroma Dorsi with (18)FDG PET/CT: a retrospective study

Elastofibroma dorsi has been described in the literature as an unusual tumor or pseudotumor. However, autopsies and imaging studies have revealed that it is a non-negligible finding.

PURPOSE

The aim of this study has been to illustrate and become familiar with this type of lesion in order to prevent misdiagnosis.

MATERIALS AND METHODS

From 3 December 2008 to 5 January 2010, 1,751 patients were evaluated with (18)FDG-PET/CT. Of these, 29 cases of elastofibroma dorsi were recorded as an incidental finding. A retrospective and descriptive analysis was performed on this study series.

RESULTS

The study showed a prevalence of 1.66%. Out of the 29 findings, 22 (75.86%) were females and 7 (24.14%) males. Seventeen (58.62%) cases were bilateral, 12 (41.38%) unilateral and the SUVmax ranged from 1.4 to 3.2. These lesions were reported as soft tissue density images with mild or moderate diffuse metabolic activity.

CONCLUSION

The elastofibroma dorsi is a relatively common finding in PET/CT that should be known in order to avoid making wrong diagnoses.

Elastofibroma dorsi

Elastofibromas are rare benign soft tissue tumours that are usually located between the scapula and the rib cage deep in the serratus anterior muscle. Their anatomical location, distinctive clinical symptoms and radiological characteristics set them apart from malignant soft tissue tumours. Although they are rare, it is necessary to be aware of this benign tumour to avoid unnecessary biopsies; surgical resection may, however, be recommended to obtain a differential diagnosis from malignant sarcomas. We report three cases of elastofibroma dorsi in a 48-year-old man, a 33-year-old woman and a 42-year-old man.

Atypical appearance of a neural foraminal elastofibroma of the lumbar spine mimicking a schwannoma on computed tomography and magnetic resonance imaging

Elastofibromas are rare benign lesions that are most commonly found in the periscapular region. We describe a rare case of a 40-year-old woman presenting with right buttock radiating pain. Computed tomography and magnetic resonance imaging revealed a homogeneously enhanced mass occupying the right neural foramen at the L4/5 level. The clinical and radiological presentation suggested a schwannoma. Pathology examination of the tissue indicated elastofibroma.

Elastofibroma dorsi: Review of eight cases

PURPOSE

Elastofibroma dorsi (ED) is a rare, benign soft tissue tumor arising from connective tissue and usually found in the subscapular region. We conducted this retrospective study to contribute to a better understanding of this tumor, the pathogenesis of which is still unclear.

METHODS

We reviewed the medical records of eight patients treated for ED at our institution between 2003 and 2008.

RESULTS

All patients were right-handed and all except one were female. The tumor was located on the right in two patients, on the left in one, and bilaterally in five. All patients underwent complete marginal resections. The resected tumors ranged in size from 5 cm to 12 cm. The only postoperative complication was seroma, observed in two patients. No recurrences have been observed in follow-up ranging from 15 days to 5 years.

CONCLUSIONS

We could not establish a relationship between the side of the dominant hand and the tumor location. If this tumor becomes symptomatic, local excision is the best treatment; however, as malignant transformation has not been reported, follow-up is recommended for asymptomatic lesions.

Bilateral elastofibroma dorsi. A case report and review of the literature

Elastofibroma is a rare benign soft tissue lesion, typically located deep under the lower pole of the scapula. It is characterized by a fibrous and adipose tissue proliferation and most frequently affects older females. Its characteristic location and its specific aspect in imaging studies most often provides the diagnosis following an incidental discovery. Nevertheless, anatomic and pathologic confirmation is necessary to formally rule out a malignant tumor diagnosis. We report a 66-year-old woman original observation; this lady's occupation involved a number of strenuous manual activities; she consulted for chronic pain related to a left subscapular mass. MRI demonstrated, in fact, two symmetrical tumor masses under each scapula. The only symptomatic lesion was surgically excised.

Elastofibroma Dorsi: Clinicopathologic Review of 6 Cases

Elastofibroma dorsi is a rare, benign lesion arising from connective tissue and usually found at the angle of the scapula. Surgical resection is often indicated in the presence of an enlarging mass or when malignancy can not be excluded. Herein we report our most recent case of elastofibroma dorsi and our review of 6 cases from the past 16 years.

Elastofibroma dorsi--differential diagnosis in chest wall tumours

Background

Elastofibromas are benign soft tissue tumours mostly of the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle with a prevalence of up to 24% in the elderly. The pathogenesis of the lesion is still unclear, but repetitive microtrauma by friction between the scapula and the thoracic wall may cause the reactive hyperproliferation of fibroelastic tissue.

Methods

We present a series of seven cases with elastofibroma dorsi with reference to clinical findings, further clinical course and functional results after resection, as well as recurrence. Data were obtained retrospectively by clinical examination, phone calls to the patients' general practitioners and charts review. Follow-up time ranged from four months to nine years and averaged 53 months.

Results

The patients presented with swelling of the infrascapular region or snapping scapula. In three cases, the lesion was painful. The ratio men/women was 2/5 with a mean age of 64 years. The tumor sizes ranged from 3 to 13 cm. The typical macroscopic aspect was characterized as poorly defined fibroelastic soft tissue lesion with a white and yellow cut surface caused by intermingled remnants of fatty tissue. Microscopically, the lesions consisted of broad collagenous strands and densely packed enlarged and fragmented elastic fibres with mostly round shapes. In all patients but one, postoperative seroma (which had to be punctuated) occurred after resection; however, at follow-up time, no patient reported any decrease of function or sensation at the shoulder or the arm of the operated side. None of the patients experienced a relapse.

Conclusion

In differential diagnosis of soft tissue tumors located at this specific site, elastofibroma should be considered as likely diagnosis. Due to its benign behaviour, the tumor should be resected only in symptomatic patients.

Bilateral elastofibroma dorsi

Elastofibromas (EFD) are rare benign soft tissue tumors that are almost always located at the inferior pole of the scapula, deep to the serratus anterior muscle. They are more frequent in elderly women. Their anatomical location and a distinctive clinical symptom distinguish them from malignant soft tissue tumours. They can usually be diagnosed on the basis of their imaging characteristics. Despite their low incidence, these lesions should be kept in mind to differentiate them from malignant tumours and to avoid unnecessary biopsies and wide or radical surgery. We present the case of a 55-year-old woman who complained of chronic pain related to a right infrascapular mass. She was diagnosed by magnetic resonance imaging (MRI) of bilateral subescapular tumor masses both compatible with elastofibroma. She underwent resection of the symptomatic right lesion through an amyotomical approach.

[Elastofibroma: imaging features]

Elastofibroma dorsi is a rare benign and slow growing fibro-proliferative lesion of unknown pathogenesis. It has a characteristic location (periscapular region) and a specific imaging appearance (songraphy, CT, MRI) allowing accurate prospective diagnosis. The recognition of this benign lesion avoids unnecessary biopsy and/or surgery. We report three cases of elastofibroma dorsi illustrating the characteristic features on sonography, CT and MRI. Involvement was bilateral in two cases.

Elastofibroma dorsi has distinct cytomorphologic features, making diagnostic surgical biopsy unnecessary: Cytomorphologic study with clinical, radiologic, and electron microscopic correlations

Elastofibroma dorsi (EFD) is a relatively rare soft tissue mass, probably of reactive nature. The lesion is typically located near the inferior margin of the scapula or between the inferior part of scapula and the chest wall in elderly women. Although location of the tumor together with the age/sex of the patients and radiologic findings is often suggestive of the diagnosis, tissue examination has been considered necessary to confirm the diagnosis. Although the histologic features of EFD are well known, there are only four single case reports of the cytologic findings in the English language literature. We describe the cytologic features of EFD in five patients with correlations to clinical, radiologic, histologic, and electron microscopic findings. The current study suggests that the fine-needle aspiration (FNA) features are highly diagnostic, permitting a firm diagnosis of EFD in a typical clinical setting and eliminating the need for preoperative histologic examination.

Bilateral elastofibroma dorsi

Elastofibroma dorsi was diagnosed in a 48-year-old woman with bilateral subscapular tumor masses diagnosed asynchronously in an interval of 4 months in spite of presence of another lesion at first admittance. She underwent subsequent resections of the lesions. They were diagnosed as elastofibroma. Reevaluation of the initial computerized tomography of thorax indicated an omitted small lesion with a 2-cm diameter and 25.2-day doubling time. Although the real neoplastic nature of elastofibroma is unknown, bilateral presence of the masses with different sizes and relatively short doubling times of the lesions must be kept in mind.