Elastofibroma dorsi: ultrasound pattern in three patients.

Elastofibroma dorsi is a rare benign tumor with a prevalence in the female population. The tumor is composed of adipose and fibrous tissue. It is typically localized at the tip of the scapular and is more frequently bilateral. Even if there are only very few reports on this topic, the incidence of the tumor seems to be less rare than expected. Elastofibroma dorsi was identified in 1961 and the first study using diagnostic ultrasound technique was published in 1996, however, since then no other major work has been produced. The purpose of the paper is to present three cases of elastofibroma dorsi, all studied by ultrasound imaging, including color and power Doppler, and by fine needle aspiration biopsy. Furthermore, in one case i.v. contrast media (Levovist) was used, and in two cases a CT and MRI evaluation was also made. Surgical excision was not performed in any of the cases. The relevant follow up was performed by clinical and ultrasound tests. In all the cases the ultrasound pattern of the elastofibroma dorsi was very similar to the surrounding muscular tissue, and neither a clear cleavage surface nor a specific vascular pattern could be evidenced. The tumor was very difficult to define from the surrounding tissue, except for a more evident coarse pattern and the same happened for the CT and MR, where a layered pattern of fatty tissue was noted. In this small cohort the tumor was mainly monolateral. The ultrasound investigation, integrated with color and power Doppler permitted a correct diagnosis, which was confirmed by the fine needle biopsy. Therefore, the less expensive ultrasound diagnosis, as a major method of screening for elastofibroma dorsi, would seem to be a reasonable proposal.