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Year : 2019  |  Volume : 34  |  Issue : 3  |  Page : 258-259  

Elastofibroma dorsi: Findings on 18F-fluorodeoxyglucose positron emission tomography-computed tomography


1 Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Department of Nuclear Medicine and PET-CT, Delhi Institute of Functional Imaging, New Delhi, India

Date of Web Publication20-Jun-2019

Correspondence Address:
Dr. Girish Kumar Parida
Department of Nuclear Medicine, Delhi Institute of Functional Imaging, Hauz Khas, New Delhi - 110 016
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnm.IJNM_6_19

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   Abstract 


Elastofibroma dorsi (EFD) is a relatively rare soft-tissue pseudotumor that arises from mesenchymal tissue. We present a case of 48-year-old woman who underwent 18F fluorodeoxyglucose (FDG) positron emission tomography-computed tomography for initial staging of suspected carcinoma of the left breast. Incidental detection of soft-tissue masses showing moderate FDG uptake was seen in the bilateral infrascapular location characteristic of EFD.

Keywords: Elastofibroma, fluorodeoxyglucose, positron emission tomography-computed tomography


How to cite this article:
Tripathy S, Parida GK, Naswa N, Subudhi K, Sreedharan Thankarajan AR, Reddy S. Elastofibroma dorsi: Findings on 18F-fluorodeoxyglucose positron emission tomography-computed tomography. Indian J Nucl Med 2019;34:258-9

How to cite this URL:
Tripathy S, Parida GK, Naswa N, Subudhi K, Sreedharan Thankarajan AR, Reddy S. Elastofibroma dorsi: Findings on 18F-fluorodeoxyglucose positron emission tomography-computed tomography. Indian J Nucl Med [serial online] 2019 [cited 2019 Jul 20];34:258-9. Available from: http://www.ijnm.in/text.asp?2019/34/3/258/260761



A 48-year-old woman underwent staging 18F fluorodeoxyglucose positron emission tomography-computed tomography (18F FDG PET-CT) for the evaluation of the left breast lesion. PET-CT revealed an FDG avid lesion in the left breast lower outer quadrant [Figure 1]a and [Figure 1]f with few ipsilateral Level I and II lymph nodes showing increased FDG uptake [Figure 1]a and [Figure 1]g. In addition to these findings, maximum intensity projection images of 18F FDG PET-CT showed symmetrical foci of FDG uptake in the bilateral posterolateral chest regions [Figure 1]a black solid arrows]. Axial CT images [Figure 1]b and [Figure 1]d solid white arrows] show soft-tissue masses in the bilateral infrascapular locations which showed moderately increased FDG uptake in the fused PET-CT images [Figure 1]c and [Figure 1]e solid white arrows]. Biopsy from the left breast lesion showed invasive ductal carcinoma.
Figure 1: (a) 18F fluorodeoxyglucose positron emission tomography-computed tomography maximum intensity projection image showing areas of moderately increased symmetrical fluorodeoxyglucose uptake in the bilateral lower chest regions shown by solid black arrows (b and d): Axial computed tomography images showing soft tissue masses in the bilateral subscapular regions which show moderate fluorodeoxyglucose uptake in the fused transaxial 18F fluorodeoxyglucose positron emission tomography-computed tomography images (solid white arrows) as seen in c, e and f - Fused transaxial fluorodeoxyglucose positron emission tomography-computed tomography image showing fluorodeoxyglucose avid lesion in the left breast parenchyma (g) - Fused transaxial fluorodeoxyglucose positron emission tomography-computed tomography image showing fluorodeoxyglucose avid left axillary lymph nodes

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Elastofibroma is a benign poorly circumscribed soft-tissue lesion classically located in the subscapular region and hence it is named as elastofibroma dorsi (EFD). It can be seen in other rare sites such as olecranon, ischial tuberosity, thighs, and subcutaneous tissue.[1],[2],[3] EFDs show diffuse low-to-moderate grade FDG uptake in a 18F FDG PET-CT scan although high FDG uptake can also be seen that may be caused due to high vascularity and abnormal fibroblastic reactive proliferation within the mass.[4],[5],[6] The correct diagnosis of this benign entity is essential to avoid any false positive results and unnecessary interventions in patients suffering from malignant conditions.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Mazzocchi M, Martano A, Di Ronza S, Dodbiba E, Divona L, Scuderi N, et al. Concomitant right subscapular and left olecranon elastofibroma followed by inversion of the lesions: Case report. Anticancer Res 2009;29:503-7.  Back to cited text no. 1
    
2.
Nishida A, Uetani M, Okimoto T, Hayashi K, Hirano T. Bilateral elastofibroma of the thighs with concomitant subscapular lesions. Skeletal Radiol 2003;32:116-8.  Back to cited text no. 2
    
3.
Shimizu S, Yasui C, Tateno M, Sato H, Homma S, Hirano E, et al. Multiple elastofibromas. J Am Acad Dermatol 2004;50:126-9.  Back to cited text no. 3
    
4.
Pierce JC 3rd, Henderson R. Hypermetabolism of elastofibroma dorsi on PET-CT. AJR Am J Roentgenol 2004;183:35-7.  Back to cited text no. 4
    
5.
Onishi Y, Kitajima K, Senda M, Sakamoto S, Suzuki K, Maeda T, et al. FDG-PET/CT imaging of elastofibroma dorsi. Skeletal Radiol 2011;40:849-53.  Back to cited text no. 5
    
6.
Blumenkrantz Y, Bruno GL, González CJ, Namías M, Osorio AR, Parma P, et al. Characterization of elastofibroma dorsi with (18) FDG PET/CT: A retrospective study. Rev Esp Med Nucl 2011;30:342-5.  Back to cited text no. 6
    


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