Elastofibroma Dorsi Detected Incidentally on Chest Computed Tomography: The Prevalence and Reporting Rate in Radiology Reports

Abstract

Background Elastofibroma dorsi (ED) is an uncommon benign connective-tissue tumor, usually seen in the subscapular region of women after the fifth decade. The study aimed to determine the prevalence, radiological characteristics, and the rates of mention in the initial radiology reports of ED incidentally detected by chest computed tomography (CT) imaging in a large population. Methodology This study was conducted at Hitit University, Erol Olçok Training and Research Hospital Radiology Department in Çorum, Turkey. A total of 3,299 patients (1,554 females, 1,745 males) who underwent non-contrast chest CT for various reasons were included in this retrospective study. The presence, side, thickness, and density of ED were investigated in these patients. Differences in gender and laterality were assessed statistically. It was also reviewed whether it was stated in the initial radiology report or not. Results ED was detected in 79 (2.4%) of 3,299 patients, in 60 (75.9%) females and 19 (24.1%) males with a median age of 57.5 years (range, 18-99 years). The risk of ED presence was determined to be 3.65-fold in females than in males. In the cases determined with ED, the median age was 75 years (range, 53-96 years), and ED was not determined in any patient aged <50 years. A statistically significant correlation was determined between age and the presence of ED (p < 0.001). No statistically significant correlation was found between age and ED thickness or density (p = 0.602, p = 0.233, respectively). It was noted that none of the patients were diagnosed in the first radiological report. Conclusions ED can be easily overlooked on cross-sectional examinations because of the similar appearance and density to adjacent structures. Knowledge of the characteristic radiological features of these lesions and increased awareness of radiologists will make early diagnosis possible in asymptomatic cases.

Keywords: computed tomography; density; elastofibroma dorsi; prevelance; radiology reports; thickness.

Figure 1. Gender distribution in all patients and the presence of ED

Figure 2. Axial non-contrast CT image of a 85-year-old male patient showing (yellow arrows) bilateral ED; soft tissue located at the posterior thoracic wall, well-circumscribed and isodense with the adjacent muscle structure.

Figure 3. Axial non-contrast CT image of a 65-year-old female patient with right unilateral ED.

The thickness measurement of ED was made by measuring the widest diameter on the axial image.

Figure 4. Axial non-contrast CT image. Density was measured to be -39 HU for right-side ED in a 68-year-old female patient.

Figure 5. Axial non-contrast CT image. Density was measured to be +80 HU for left-side ED in a 78-year-old female patient.