title: Elastofibroma: a rare soft tissue tumour with a pathognomonic anatomical location and clinical symptom.
abstract: BACKGROUND
  Elastofibromas are rare benign soft tissue tumours that are almost always located at the inferior pole of the scapula, deep to the serratus anterior muscle. Their anatomical location and a distinctive clinical symptom distinguish them from malignant soft tissue tumours.
  
  
  METHODS
  A prospective histo-pathological database of all soft tissue tumours referred for treatment to the Royal Marsden Hospital between 1995 and 2003 was searched. Seven patients treated in this institution with a histological diagnosis of elastofibroma were identified.
  
  
  RESULTS
  The usual presenting symptoms were that of a mass at the angle of the scapula (7/7), and clunking of the scapula on shoulder abduction (5/7). Pain was an infrequent symptom (1/7). Imaging by CT or MR usually indicated an indeterminate soft tissue neoplasm deep to the peri-scapular muscles, but the histological diagnosis was confirmed pre-operatively by core biopsy in all patients. Subsequent surgical excision was only performed if symptoms were severe.
  
  
  CONCLUSIONS
  The clinical presentation of these benign neoplasms is typical and the suspected clinical diagnosis can be confirmed easily by core biopsy. Surgery can be safely reserved for symptomatic patients.
authors.affiliation: Sarcoma and Melanoma Unit, Royal Marsden Hospital, Fulham Road, Chelsea, London SW3 6JJ, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Hayes
authors.forename: N
authors.initials: N
authors.lastname: Alexander
authors.forename: M A
authors.initials: MA
authors.lastname: Clark
authors.forename: J M
authors.initials: JM
authors.lastname: Thomas
mesh_terms: D000368:Aged; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012540:Scapula; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome