title: Elastofibroma dorsi: diagnostic and therapeutic algorithm.
abstract: BACKGROUND
  Elastofibroma typically occurs in the subscapular region of elderly individuals and has a high incidence in Kyushu and the surrounding islands in southern Japan. The treatment of this lesion is somewhat controversial.
  
  
  METHODS
  Eleven patients with a diagnosis of elastofibroma dorsi were identified from the unit's database. The clinical presentation, diagnosis, and treatment options were evaluated.
  
  
  RESULTS
  There were 6 men and 5 women, with a mean age of 66.7 years (range, 49-82 years). Bilateral lesions were found in 2 patients. The mean lesion size was 6.6 cm in greatest dimension (range, 5-9 cm). The mean follow-up of both surgically and conservatively managed patients was 16.4 months (range, 2-69 months). All were diagnosed by magnetic resonance imaging, and early in the series, 1 also underwent an open biopsy to confirm the diagnosis. Five patients underwent marginal excision of the lesion. No recurrence was observed at last follow-up.
  
  
  CONCLUSIONS
  Magnetic resonance imaging can be used as a first-line investigation of the lesion, and biopsy is not necessary in most cases. We suggest that a conservative "wait-and-watch" attitude is reasonable and may be considered even when patients are symptomatic.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan. jnishio@cis.fukuoka-u.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Nishio
authors.forename: Teruto
authors.initials: T
authors.lastname: Isayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Naito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012540:Scapula; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed