Retrospective analysis of 73 cases of elastofibroma

Abstract

Objective: Elastofibroma is a rare soft-tissue tumour. This study retrospectively analysed and summarised the clinical, imaging and typical pathological features, together with the short- and long-term surgical outcomes of patients with pathologically confirmed soft-tissue elastofibroma to improve their management.

Materials and methods: We enrolled 73 patients with pathologically confirmed soft-tissue elastofibroma from January 2010 to December 2018. The general, clinical, diagnostic and treatment-related data, operation notes, pathological examination results and follow-up status were obtained by reviewing inpatient medical records. Disease onset age, sex, tumour location and size were statistically analysed using the chi square and rank sum tests.

Results: A total of 90 lesions from 73 patients were examined. Among these, 56 patients had single lesions: 27 were under the right scapula, 26 were under the left scapula, 1 at the umbilicus, 1 on the aortic valve, 1 on the right hip and 17 at the bilateral inferior angles of the scapula. The average age at onset was 56.4 years (range: 6-82 years). The male-to-female incidence ratio was about one to three. Tumour diameter and follow-up duration ranged from 2cm to 12cm and from one month to nine years, respectively; recurrence was not observed. The main postoperative complication was wound effusion, occurring in 24 sites among the 90 lesions, corresponding to an incidence rate of 26.7%.

Conclusions: A correct diagnosis of elastofibroma can be made prior to surgical resection by examining typical clinical features and characteristic imaging findings. Short- and long-term outcomes of local excision are good, with no further recurrence.

Keywords: Elastofibroma; Magnetic resonance imaging; Pathological examination; Tumour; Ultrasonography; X-ray computed tomography.

Figure 1

Age and disease course distribution of the cohort (F, female; M, male).

Figure 2

Ultrasound showing the characteristic findings.

Figure 3

(a) Computed tomography (CT) showing zebra pattern of fat density images with high (elastic fibres) and low (adipose tissue) density areas inside the lesion. (b) Contrast enhanced CT showing no definite enhancement.

Figure 4

(a) T1-weighted magnetic resonance imaging (MRI) showing isointensity of the fibrous tissue (relative to the skeletal muscle) and hyperintensity of the fatty tissue. (b, d) Axial and coronal T2-weighted MRI showing hyperintensity of the intralesional stripes. (c, e) Axial and coronal T2-weighted fat-suppressed MRI showing significant hypointensity of the intralesional stripes. (f, g) Diffusion-weighted imaging and apparent diffusion coefficient revealing isointensity of the lesions. (h) Partial enhancement of the tumour following gadolinium injection.

Figure 5

(a, b) Gross examination findings of the tumours. (c–e) Histopathological appearance of the tumours.