Şükran Güzel1, Selin Özen1, Seyhan Sözay1, Mehmet Dalokay Kılıç2

1Department of Physical Medicine and Rehabilitation, Başkent University Faculty of Medicine, Ankara, Turkey
2Department of Thoracic Surgery, Başkent University Faculty of Medicine, Ankara, Turkey

Keywords: Back pain, benign neoplasms, diagnostic errors.

Abstract

Elastofibroma dorsi (ED) is a rare, benign soft tissue tumor which often occurs in the subscapular region of elderly individuals and shows a female predominance. While many patients remain asymptomatic, ED can cause pain in the periscapular region. The clinical signs of ED are non-specific and variable which can result in misdiagnoses; it is often confused with rotator cuff and cervical spine pathologies. In this article, we present the case of a 78-year-old female patient with persistent back and shoulder pain. The patient was admitted to various clinics over a number of years for diagnostic investigations and treatment. However, the true etiology of back pain was never established and treatments were applied without any positive effect. Finally, when the patient presented to our clinic, a mass was detected in the right subcapular region. Thoracic computed tomography imaging was consistent with a diagnosis of ED. Due to the patient’s persistent back pain, surgical excision of the tumor was performed. The pathology report confirmed the diagnosis. This case emphasizes the importance of a thorough examination in patients who may initially only have very subtle signs of the underlying pathology. This case also highlights the importance of re-visiting initial evaluations and differential diagnoses when faced with a difficult case of persistent back and shoulder pain so to avoid misdiagnoses and unnecessary treatments.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.