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Elastofibroma dorsi is a rare, slow-growing, benign soft tissue pseudotumor composed of fibroelastic tissue, classically located in the infrascapular region between the lower pole of the scapula and thoracic wall. It is considered a reactive lesion rather than a true neoplasm.

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https://www.youtube.com/watch?v=MRgTr_TXRqQ

Epidemiology

• Typically affects elderly individuals (50–70 years).
• Female predominance (F:M ≈ 5:1).
• Often bilateral (up to 60% cases if imaged carefully).
• Rarely symptomatic; usually incidental.

Etiopathogenesis

• Reactive process due to chronic mechanical friction** between scapula and chest wall → fibroelastic tissue proliferation.
• Histology: dense collagen bundles interspersed with abnormal elastic fibers and fat.
• Genetic predisposition also suggested (familial clustering).

Clinical Features

Firm, slow-growing swelling beneath scapula. May be asymptomatic, or cause:

• Scapular “snapping” or clunking.
• Periscapular pain/discomfort.
• Restricted shoulder movement (rare).

Radiology