CTICasesMultiple Elastofibromas (including Elastofibroma Dorsi)
Imaging findings
CT and PET/CT imaging demonstrate soft tissue masses located deep to the serratus anterior and latissimus dorsi muscles, just below the scapula, representing classic elastofibromas. Interestingly, this patient demonstrates multiple lesions, including typical bilateral subscapular lesions as well as separate, smaller elastofibromas located higher in the posterior neck. The lesions can show marked metabolic activity on FDG-PET/CT, which can act as a pitfall mimicking malignant disease.
Key takeaways
Elastofibroma dorsi is a benign, slow-growing pseudotumor typically located in the infrascapular region deep to the serratus anterior and latissimus dorsi. It is more common in older females and often bilateral. Recognizing its classic location and striated, fatty-attenuated appearance on CT is crucial to avoid unnecessary biopsies. Despite being benign, they can be highly FDG-avid on PET/CT.
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