Images of Musculoskeletal Oncology

Elastofibroma

An 81 year old woman noted pain and swelling behind both scapulae for many months. Patient frequently walked her two large dogs on the beach, and attempted to control them by tugging on their leashes. She was otherwise in good health. On examination there were two slightly tender masses, each under a scapula.
The MRI’s reveal large subscapular soft tissue masses. The impression was bilateral elastofibroma under each scapulae. Patient stated she wished to have these masses removed because they were painful.
The masses were removed at six month time intervals. The 12cm soft tissue mass can be seen.
The photomicrograph demonstrates broad collagenous strands and densely packed fragmented elastic fibers with many round shapes.
At two years postop, the patient was quite comfortable and continued to have full shoulder motion.

Learning Issues:

1. Elastofibromas are most likely are a result of repetitive microtraumas by friction between the scapula and thoracic wall, causing a reactive hyperproliferation of fibroelastic tissue. These lesions are not neoplastic.

2. Patients may be relieved of symptoms by altering their physical activity, or by surgical removal.


Images of Musculoskeletal Oncology
University at Buffalo Department of Orthopaedics