Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia.
BMC Musculoskelet Disord. 2020 Jan 8;21(1):16. doi: 10.1186/s12891-020-3037-7.
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.
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.
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.
弹性纤维瘤是一种良性软组织肿瘤，其特征是在胶原和成熟脂肪组织的基质中存在弹性纤维。通过 CT 图像研究显示，其患病率为 2.73%。然而，多发性弹性纤维瘤并不常见。
我们报告了一例同时发生在肩胛下区和臀区的双侧弹性纤维瘤病例。一名 63 岁男性患者，背部上侧逐渐出现无痛性肿胀，病史 6 个月。体格检查发现双侧肩胛下区有坚实、无痛的肿块；在前臂伸展时这些肿块更加明显。增强 CT 显示前锯肌深面双侧肩胛下区边界清楚的肿块，以及双侧臀区边界不清楚的肿块，其衰减与相邻骨骼肌相似。磁共振成像显示混杂性肿块，内部有脂肪条纹，符合弹性纤维瘤的表现。根据影像引导下的核心针活检结果，做出了弹性纤维瘤的组织病理学诊断。患者接受了双侧肩胛下弹性纤维瘤切除术，无术后并发症。由于臀区肿块是偶然发现的，因此不需要手术治疗。
多发性弹性纤维瘤并不常见。本报告描述了一例罕见的多发性弹性纤维瘤病例及其典型的影像学特征，并提醒我们，弹性纤维瘤并非仅局限于肩胛旁区域。
