Elastrofibromas are rare lesions characterized by collagen and elastic fiber deposition. They are generally found in soft tissues and throughout the gastrointestinal tract. The pathogenesis of this lesion is still uncertain, but it is hypothesized to be a reactive process. We present a case of an appendiceal elastofibroma, a unique anatomic location that necessitated surgical removal, with pathologic findings suggestive of an inciting event from a sclerosed vascular abnormality.

Oral elastofibromatous lesions (OEFLs) are rare benign tumor-like lesions of the oral cavity, which are characterized by marked hyperplasia of elastic fibers. A case of OEFL on the tip of the tongue of an 83-year-old male is presented. The lesion was a painless, yellowish-white, smooth-surfaced, elastic-soft, well-demarcated, slightly flattened, round plaque-like mucosal lesion, measuring about 4 x 3 mm. The lesion was excised under local anesthesia with the clinical diagnosis of an irritation fibroma and a benign tumor including a lipoma, and diagnosed histopathologically as an OEFL. Four years and nine months after the surgery, no abnormality was observed at the surgical site, and there were no signs of recurrence. In addition to a report of the case, the clinical and histopathological features of 14 similar cases reported in the English literature were reviewed.

OBJECTIVE: In this work, we have used histopathology as the gold standard for the diagnosis, calculated the sensitivity and positive predictive value (PPV) of computed tomography (CT), and analyzed the CT and clinical characteristics of pathologically proven elastofibromas.
METHODS: A systematic retrospective analysis was performed on all patients with infrascapular lesions who were treated in the hospital from 2006 to 2018. CT and histopathological examinations were performed for all cases, and the CT sensitivity and PPV for the diagnosis of elastofibroma were calculated. 12 of 53 cases (20 lesions) underwent enhanced CT scan after CT plain scan, and the related clinical and CT features of elastofibromas have been discussed.
RESULTS: Of the 54 patients treated during the study, CT diagnosis was consistent with histopathology in 53 cases. One was a false-positive patient. The PPV and sensitivity of the CT in the diagnosis of elastofibroma were 93.3% (95% CI 68.0%-99.8%) and 100%, respectively. The CT values of 12 patients with 20 lesions on plain and enhanced scans were statistically significant (P=0.001). The prevalence of elastofibromas in males and females was statistically significant (P=.000). There was no statistically significant difference in the incidence of left and right elastofibromas (P=0.752). There was no significant difference in the volume of left and right lesions (P=0.209) and the volume of elastofibromas between males and females (P=.474).
CONCLUSIONS: CT is the most practical tool for the evaluation of elastofibromas in the infrascapular region.

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.

OBJECTIVE: To evaluate the frequency, imaging findings, and patient demographics of synchronous elastofibroma dorsi (ED) and pelvic elastofibromas.
METHODS: Image archives between 2011 and 2021 were retrospectively searched for CT and MRI reports including the keyword \"elastofibroma\". Patients with concomitant CT and/or MRI of the chest and pelvic regions were included. The greatest thickness and side of ED were noted. Subsequently, pelvic soft tissues were evaluated for a soft tissue mass with similar radiological features to ED. When detected, its location, greatest transverse diameter, and ischiofemoral space widths were noted. Wilcoxon matched-pairs signed-rank and Mann-Whitney U-tests were performed when appropriate. Pearson\'s correlations were used to assess the association of presence of subgluteal-ischiofemoral elastofibromas (SGIFE) and ED thickness. The model discrimination of ED thickness was evaluated by calculating the AUC of the ROC.
RESULTS: Eighty-eight patients (Male:Female = 8:80) with a mean age of 70.6 (±10.3) years were included. 96.6 % of patients had bilateral ED. 18.2 % of patients (all females) had at least one concomitant SGIFE. Patients with SGIFE had significantly thicker ED (p < 0.001 right; p = 0.049 left). There was a significant positive correlation between the thickness of ED and presence of SGIFE (r = 0.43, p < 0.001 right; r = 0.25, p = 0.019 left). An AUC of 0.781 (p < 0.001, 95 %-CI:0.675-0.887) and 0.659 (p = 0.049, 95 %-CI:0.523-0.794) were revealed regarding the presence of ipsilateral right and left SGIFE, respectively.
CONCLUSIONS: Concomitant SGIFE may accompany ED in up to 18.2% of cases, particularly in women with thick ED. Knowledge of this co-occurrence and the described SGIFE characteristics can facilitate correct diagnosis.

Elastofibroma dorsi is an uncommon benign soft-tissue tumor with uncertain pathogenesis (Medicina (Kaunas), 2021; 57, 370). Surgical excision is the therapeutic option for symptomatic patients. A pathological study confirms the diagnosis after surgery. The prognosis is excellent with extremely rare recurrence cases (Anticancer Res, 2021, 41, 2211).

Elastofibroma is a benign soft tumor that is composed of elastic fibers in a background of collagenous and adipose tissue. However, the presence of multiple elastofibromas is considered a rare occasion. We report the case of a 39-year-old man who presented to our general practice clinic with a complaint of upper back swelling for the last three months. The swelling was completely painless. It was not associated with ulceration of the overlying skin. He reported that the swelling had not been increasing in size. There was no history of anorexia, weight loss, or preceding trauma. On examination, both shoulders had a normal range of motion with no restriction due to the mass lesions. To further characterize the mass lesions, the patient underwent a computed tomography scan of the thorax. It demonstrated bilateral lenticular subscapular mass lesions that were ill-defined but had similar attenuation to that of adjacent skeletal muscle along with the presence of interspersed streaks of fat. Such findings represent the diagnosis of elastofibroma. However, the patient was concerned about the possibility of the malignant nature of these lesions and insisted on having the surgical resection of the mass. The histopathological findings confirmed the diagnosis of elastofibroma. Elastofibroma is a benign soft tissue tumor that is diagnosed incidentally in the majority of cases. However, multiple elastofibroma, as in the present case, is considered unusual. The case demonstrated the radiological and histopathological features of elastofibroma. The imaging findings are characteristics and can prevent unnecessary biopsy or surgical intervention. However, if clinically indicated, surgical resection is considered curative.

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Elastofibroma dorsi is an uncommon benign fibroblastic pseudotumor that typically occurs in the subscapular region of middle-aged or older individuals. The pathogenesis is still unclear and a matter of debate. Magnetic resonance imaging can be used as a first-line investigation of the lesion and reveals a lenticular soft-tissue mass with a signal intensity similar to that of skeletal muscle interlaced with strands of fat. Biopsy is not necessary if all pathognomonic criteria are present. A conservative \"wait and see\" attitude is reasonable and immediate surgery is no more the standard treatment of elastofibroma dorsi. This review provides an updated overview of the diagnosis, management and pathogenesis of elastofibroma dorsi. We also discuss recent advances in our understanding of genomic alterations in elastofibroma dorsi.

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.