Overview
Elastofibroma dorsi is a benign, fibrous soft tissue lesion typically found in the posterior chest wall, characterized by the presence of abnormal elastin-like fibers and globules derived from collagen denaturation 1. It is considered a reactive fibromatosis rather than a neoplastic process due to its morphology and clinical behavior 1.Diagnosis
Clinical Presentation: Often asymptomatic, located in the posterior thoracic wall 1.
Imaging: MRI and CT scans show well-defined masses with characteristic signal intensity patterns 1.
Histopathology: Key features include storiform arrangement of fibroblastic cells and distinctive elastoid material composed of denatured collagen 1.
Differential Diagnosis: Excludes true neoplasms like lipoma, fibrosarcoma, and desmoid tumors based on histological features 1.Management
Surgical Excision: Recommended for definitive treatment, especially for symptomatic lesions or when diagnosis is uncertain 1.
Observation: May be appropriate for asymptomatic, well-localized lesions 1.
Adjuvant Therapy: Not typically required for benign behavior 1.Special Populations
Pregnancy: No specific guidelines provided; management similar to non-pregnant patients 1.
Pediatrics: Rare occurrence; management principles similar to adults 1.
Elderly: Surgical risks should be carefully considered; conservative management may be preferred in high-risk patients 1.
Comorbidities: Surgical approach tailored to patient comorbidities; close perioperative management advised 1.Key Recommendations
Confirm diagnosis through histopathological examination demonstrating characteristic elastoid material 1 (Evidence: Strong).
Consider surgical excision for definitive treatment, particularly for symptomatic cases 1 (Evidence: Moderate).
Asymptomatic lesions may be managed conservatively with regular imaging follow-up 1 (Evidence: Expert opinion).References
1 Tighe JR, Clark AE, Turvey DJ. Elastofibroma dorsi. Journal of clinical pathology 1968. link