Triple elastofibromas located in the supra- and infrascapular regions-a case report

We report a case of triple elastofibromas located in the supra- and infrascapular regions. A 61-year-old female with a history of bilateral elastofibroma in the typical subscapular region (6 years before) was admitted for the evaluation of a left-sided suprascapular mass that she had first noted 3 months before. On physical examination, a firm, painless, mobile mass was palpated in the subcutaneous tissue. The patient had not observed any changes of the two known lesions over the past 6 years. The patient denied a family history of elastofibroma. The signal characteristic on T1- and T2-weighted images as well as contrast enhancement curves on dynamic study was identical in all three masses. Ultrasound-guided biopsy performed before surgical intervention confirmed the diagnosis of elastofibroma. This case report has a teaching value as, to our knowledge, it is the only one in the literature with images of synchronous elastofibromas documented by dynamic contrast-enhanced MRI. In cases of elastofibroma with diagnostic difficulties, particularly in uncommon sites, a dynamic contrast-enhanced MRI may help to establish the proper diagnosis. This case report gives an example of rare multiple elastofibromas, presents current diagnostic imaging methods, and reminds us that elastofibroma is not exclusive to the posterior thoracic region.