Elastofibroma dorsi. Study of two cases and magnetic resonance imaging findings

Two cases of elastofibroma dorsi (one bilateral, one unilateral) in the periscapular and infrascapular region of two male patients are described. Magnetic resonance imaging revealed a tumorous mass of typical low signal intensity with interspersed areas of high signal intensity on T1 and T2 weighted spin echo sequences. In contrast to previous studies that reported mild enhancement within elastofibromas after administration of intravenous contrast agent, marked enhancement in one of two elastofibromas was found. This is considered to be atypical for benign lesions. After biopsy and histopathologic examination, an intended marginal resection was performed in both cases. Laboratory values, radiographs, and computed tomography may not be helpful in differentiating elastofibroma from malignant tumors. In addition to careful clinical investigation, magnetic resonance imaging is the method of choice leading to a presumptive diagnosis. Because marked enhancement on contrast agent images was observed, which is characteristic for malignant tumors, one should be aware that this feature does not exclude the presence of elastofibroma. Accurate diagnosis should be made preferably by biopsy and histopathologic evaluation before additional treatment is administered. Marginal resection is curative in patients with symptoms. Despite its low incidence, this pseudotumoral lesion should be known generally to differentiate it from malignant tumors and to avoid unnecessary wide or radical surgery.