Elastofibroma dorsi: an unusual cause of shoulder pain

Objectives: We evaluated patients who underwent surgi¬cal treatment for elastofibroma dorsi (ED). Methods: The study included 13 patients (11 women, 2 men; mean age 54 years; range 43 to 74 years) who were treated surgically for ED that caused persistent symptoms. Involvement was on the right in six patients, on the left in five patients, and bilateral in two patients. All the patients presented with a mass lesion that became apparent at the lower corner of the scapula on shoulder flexion and adduc¬tion. The complaints were swelling and pain on the back in nine patients, and a snapping sound on shoulder move¬ments together with pain in four patients. Diagnosis of ED was made by magnetic resonance imaging (n=10) and computed tomography (n=3), with no utilization of preop- erative biopsy. Marginal tumor excision was performed in all cases. Evaluation for recurrence was made by ul- trasonography. The mean follow-up period was 32 months (range 8 to 90 months). Results: All the masses were located at the inferior corner of the scapula, with adherence to the thorax between the serratus anterior, rhomboid, and latissimus dorsi muscles. The mean size of the surgical specimens was 9x6x3 cm (range 5x3x1 to 14x8x3 cm). Clinical diagnosis was con¬firmed by histopathologic examination in all cases. All ma¬jor complaints resolved after surgery. Hematoma occurred in four cases postoperatively, but resolved without the need for surgical intervention. No recurrence was observed. Conclusion: Even though ED is a rare clinic entity, it should be recalled while evaluating shoulder pathologies. Marginal excision is adequate for the treatment of patients with sustaining complaints.