Subscapular elastofibroma: a reactive pseudotumor

Six cases of elastofibroma located in the subscapular region are reported. The age of the patients ranged from 45 to 71 years (mean 59.5 years). In three cases the symptoms were posterior shoulder pain with arm motion, and one of these also had a snapping scapula. Two cases had tumor prominence as the only symptom, and in one case the tumor was found accidentally while thoracotomy was being performed. On magnetic resonance imaging a nonencapsulated soft-tissue mass closely related to the thoracic wall and elevating the scapula was identified. At surgery the tumor was densely adherent to the periosteum of the ribs and the external fascia of the rib cage, and peripherally it proceeded into the loose connective tissue of the subscapular space. Local excision was performed. At follow-up 1 to 8 years after surgery no recurrence was observed, and all patients with painful lesions had complete relief of pain.