Elastofibroma: management and surgical outcome

Abstract

Elastofibroma is a benign slow-growing neoplasm of soft tissues, originally defined Elastofibroma dorsi because of the typical  localization in the connective tissue placed between the bottom corner of the scapula and the chest wall.
From 1990 to 2013 at our center, 115 patients underwent elestofibroma surgical removal, including 2 bilateral and one relapsed. For all the patients ultrasound preoperative examination was requested, sometimes with a diagnosis of lipoma  or fibrolipoma because of the rarity of this type of lesion and therefore the lack of experience of the radiologists.
In all 115 patients the lesion was detected and removed, only in 7 cases it was necessary, intraoperatively, to mobilize the upper limb and shoulder in order to better visualize the lesion.
On the operating table the lesion was situated below the muscle planes and looks like a solid mass, oval, with a pole firmly attached to the periosteum of the ribs and intercostal ligaments, with net margins and a diameter of 5-10 cm.
The sides not attached to the chest wall were in continuity with the adipose tissue. The cutting surface was pink-graysh, with fibrous appearance. Foci of cystic degeneration interspersed with islands of fat that are vaguely reminiscent of the fibrolipoma could be found.  The treatment of choice is the surgical excision and subsequent histological examination solve the diagnostic dilemma.
If the removal is radical, it is definitve because the lesion has no tendency to relapse.