Elastofibroma dorsi

Elastofibroma dorsi is a rare, benign soft tissue pseudotumor characterized by the slow-growing accumulation of abnormal elastic fibers and fibrous tissue. It typically develops in the subscapular region, between the lower scapula and the chest wall, most commonly on the right side, though bilateral involvement occurs in a significant proportion of cases. The mass is composed of degenerated elastic fibers interspersed with collagen and mature adipose tissue. Elastofibroma dorsi predominantly affects older adults, particularly women over the age of 55, and is thought to arise from reactive mechanical friction between the scapula and the thoracic wall rather than being a true neoplasm. Many patients are asymptomatic, with the mass discovered incidentally on imaging studies such as CT or MRI performed for other reasons. When symptomatic, patients may experience a palpable swelling or mass beneath the scapula, mild to moderate pain, a sensation of heaviness, and occasionally a snapping or clunking sensation during shoulder movement. The condition primarily affects the musculoskeletal and connective tissue systems. Diagnosis is often made clinically and confirmed by characteristic imaging findings, though biopsy may be performed to exclude malignant soft tissue tumors. Treatment is generally conservative for asymptomatic cases, with observation and reassurance being appropriate. For patients who experience significant pain or functional limitation, surgical excision (marginal resection) is the standard treatment and is usually curative, with low recurrence rates. The etiology remains incompletely understood, though repeated mechanical stress and possible genetic predisposition have been proposed as contributing factors. Some familial clustering has been reported, suggesting a possible hereditary component in certain cases.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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