Multifocal concomitant scapulothoracic and subgluteal-ischiofemoral elastofibromas

Eur J Radiol. 2023 Feb:159:110683. doi: 10.1016/j.ejrad.2022.110683. Epub 2022 Dec 26.

Abstract

Purpose: To evaluate the frequency, imaging findings, and patient demographics of synchronous elastofibroma dorsi (ED) and pelvic elastofibromas.

Methods: Image archives between 2011 and 2021 were retrospectively searched for CT and MRI reports including the keyword "elastofibroma". Patients with concomitant CT and/or MRI of the chest and pelvic regions were included. The greatest thickness and side of ED were noted. Subsequently, pelvic soft tissues were evaluated for a soft tissue mass with similar radiological features to ED. When detected, its location, greatest transverse diameter, and ischiofemoral space widths were noted. Wilcoxon matched-pairs signed-rank and Mann-Whitney U-tests were performed when appropriate. Pearson's correlations were used to assess the association of presence of subgluteal-ischiofemoral elastofibromas (SGIFE) and ED thickness. The model discrimination of ED thickness was evaluated by calculating the AUC of the ROC.

Results: Eighty-eight patients (Male:Female = 8:80) with a mean age of 70.6 (±10.3) years were included. 96.6 % of patients had bilateral ED. 18.2 % of patients (all females) had at least one concomitant SGIFE. Patients with SGIFE had significantly thicker ED (p < 0.001 right; p = 0.049 left). There was a significant positive correlation between the thickness of ED and presence of SGIFE (r = 0.43, p < 0.001 right; r = 0.25, p = 0.019 left). An AUC of 0.781 (p < 0.001, 95 %-CI:0.675-0.887) and 0.659 (p = 0.049, 95 %-CI:0.523-0.794) were revealed regarding the presence of ipsilateral right and left SGIFE, respectively.

Conclusion: Concomitant SGIFE may accompany ED in up to 18.2% of cases, particularly in women with thick ED. Knowledge of this co-occurrence and the described SGIFE characteristics can facilitate correct diagnosis.

Keywords: Computed tomography; Deep gluteal space; Elastofibroma; Ischiofemoral space; Magnetic resonance imaging.

MeSH terms

  • Aged
  • Female
  • Fibroma* / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies
  • Soft Tissue Neoplasms* / diagnostic imaging
  • Thorax