Elastofibroma dorsi - Study of two cases and magnetic resonance imaging findings

Two cases of elastofibroma dorsi (one bilateral, one unilateral) in the per iscapular and infrascapular region of two male patients are described. Magn etic resonance imaging revealed a tumorous mass of typical low signal inten sity with interspersed areas of high signal intensity on T1 and T2 weighted spin echo sequences. In contrast to previous studies that reported mild en hancement within elastofibromas after administration of intravenous contras t agent, marked enhancement in one of two elastofibromas was found. This is considered to be atypical for benign lesions. After biopsy and histopathol ogic examination, an intended marginal resection was performed in both case s. Laboratory values, radiographs, and computed tomography may not be helpf ul in differentiating elastofibroma from malignant tumors. In addition to c areful clinical investigation, magnetic resonance imaging is the method of choice leading to a presumptive diagnosis. Because marked enhancement on co ntrast agent images was observed, which is characteristic for malignant tum ors, one should be aware that this feature does not exclude the presence of elastofibroma. Accurate diagnosis should be made preferably by biopsy and histopathologic evaluation before additional treatment is administered. Mar ginal resection is curative in patients with symptoms. Despite its low inci dence, this pseudotumoral lesion should be known generally to differentiate it from malignant tumors and to avoid unnecessary wide or radical surgery.