Case 13
History:
49 year old male with left shoulder discomfort
Findings:
Chest CT showing a soft tissue lesion located along the posterior left chest wall, isodense to the adjacent musculature.
Diagnosis:
Elastofibroma Dorsi of the Chest Wall
Discussion:
Elastofibroma is a benign pseudotumoral reactive fibrous lesion of the chest wall likely secondary to chronic mechanical friction between the tip of the scapula and the chest wall. Characteristically located between the chest wall and the inferior tip of the scapula, but 5% of elastofibromas are found elsewhere. Most lesions are asymptomatic. Bilateral lesions are common but are often asymmetric. CT shows a mass with soft-tissue attenuation with striations of fat attenuation. On MR imaging, elastofibroma is a poorly circumscribed semilunar, heterogeneous soft-tissue mass, with signal intensity similar to that of skeletal muscle interlaced with strands of fat. Surgery is curative; recurrences (7%) are probably caused by incomplete excision.
