From the Research
Definition and Characteristics of Elastofibroma
- Elastofibroma is a benign slow-growing neoplasm of soft tissues, typically located in the connective tissue between the bottom corner of the scapula and the chest wall 1.
- It is a rare, pseudo-tumor that arises at the inferior pole of the scapula, often mistaken for soft tissue sarcomas due to its tissue of origin and size 2.
- The lesion is usually solid, oval, and firmly attached to the periosteum of the ribs and intercostal ligaments, with a diameter of 5-10 cm 1.
Clinical Presentation and Diagnosis
- Elastofibroma can be found incidentally on radiologic imaging or due to clinical symptoms, and patients may become apprehensive due to its similarity to new malignancy or recurrence of prior malignancy 3.
- Diagnosis can be confirmed by percutaneous biopsy, but it is not necessary if all pathognomonic criteria are present, and magnetic resonance imaging can be used as a first-line investigation 4.
- Fine needle aspiration (FNA) is a commonly used technique to diagnose elastofibroma, but the collagenous nature of the mass often results in a paucicellular FNA smear, leading to false-negative reports 5.
Treatment and Management
- The treatment of choice is surgical excision, but it is only recommended in symptomatic cases, and a conservative "wait and see" attitude is reasonable for asymptomatic patients 3, 4.
- If the removal is radical, it is definitive because the lesion has no tendency to relapse 1.
- Soft tissue masses greater than 5 cm in diameter should prompt the clinician to exclude soft tissue sarcoma, and the diagnosis of elastofibroma may be alluded to by its typical presentation 2.