2004 Texas Radiological Society CHEST UNKNOWN CASE

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2004 Texas Radiological SocietyCHEST UNKNOWN
CASE

• Justin Q. Ly, MD
• Douglas P. Beall, MD
• Department of Radiology
• Wilford Hall Medical Center
• San Antonio, TX
• Oklahoma University Health Science Center
• Oklahoma City, OK

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73 year old female with palpable mass at the
right posterolateral chest wall
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Diagnosis?

• Elastofibroma Dorsi

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Elastofibroma Dorsi
Benign, fibroelastic pseudotumor of unknown
cause Sub- or infrascapular regions of chest
wall (99) Found at autopsy in 24 of women and
11 of men, gt 55 years 1/3 pts had family
history of elastofibroma In patients who are
symptomatic (lt 50),
stiffness is most common complaint (25)
(pain relatively uncommon lt10)
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Elastofibroma Dorsi
Usually deep to serratous anterior, rhomboid,
and latissimus dorsi muscles firmly attached to
chest wall Bilateral lesions are quite
common Synchronous infraolecranon lesions also
common Other reported sites of elastofibromas
include overlying greater trochanter and
ischial tuberosity, deltoid region,
hands and feet, and cervical
epidural space Size ranges from 1-20cm
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Elastofibroma Dorsi
On CT, elastofibromas appear as poorly defined,
soft-tissue masses similar in attenuation to
skeletal muscle, containing linear low
attenuation (fat) streaks MR shows mass with
signal intensity similar/equal to that muscle on
both T1- and T2-weighted images. Interlaced
throughout mass are linear areas of fat signal
intensity In asymptomatic patients no
treatment is required (no risk of malignant
degeneration). Surgical excision for symptomatic
patients
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2004 Texas Radiological SocietyCHEST UNKNOWN
CASE Elastofibroma

• Justin Q. Ly, MD
• Douglas P. Beall, MD
• Department of Radiology
• Wilford Hall Medical Center
• San Antonio, TX
• Oklahoma University Health Science Center
• Oklahoma City, OK