Possible Relationship Between Bilateral Elastofibroma Dorsi and Hypermastia İlknur Keskin 1 , Bircan Kolbaşı 1 , Aslı Akhan 2 , Hasan Çelik 3 , Mustafa Hancı 3 , Mustafa Keskin 3 1 Department of Histology and Embryology, İstanbul Medipol University School of Medicine, İstanbul, Turkey 2 Department of Pathology, İstanbul Medipol University School of Medicine, İstanbul, Turkey 3 Department of Plastic Reconstructive and Aesthetic Surgery, İstanbul Medipol University School of Medicine, İstanbul, Turkey Elastofibroma dorsi (EFD) is a rare, benign, soft tissue tumor with an unclear pathogenesis, typically localized to the subscapular region. It occurs within the periscapular area between the ribs and dorsal chest wall muscles. Repetitive microtrauma by friction be- tween the lower part of the scapula and the thoracic wall may cause reactive hyperproliferation of the fibroblastic tissue. This view has been supported by the higher prevalence of EFD, particularly among individuals who perform hard manual labor. EFD can, however, also be observed in those who have never performed hard manual labor and particularly in women over the age of 50. In this report, we present a case of bilateral EFD in a 52-year old woman with bilateral hypermastia, and examine the possible correlation between hypermastia and EFD. Keywords: Elastofibroma dorsi, breast hypertrophy, hypermastia Abstract DOI: 10.5152/TurkJPlastSurg.2017.2131 Case Report INTRODUCTION Elastofibroma dorsi (EFD) is a rare, benign soft tissue tumor typically localized to the subscapular region. It is mostly seen on the scapular plane, bilaterally or unilaterally, in adults over mid-age. These masses appear poorly circumscribed since they are deeply located in the musculature. They are often asymptomatic and grow slowly. Uncertainties remain about its pathogenesis. Although The World Health Organization has defined elastofibroma as a benign fibroblast tumor, many authors do not accept it as a real tumor, but rather as the hyperplasia of elastic tissues associated with the mechanical irritation caused by the friction between the scapula and the thoracic wall. It is suggested that repetitive trauma caused by friction leads to an overproduction of the collagenous connective tissue, and thereby to the degeneration of the collagen fibers, which are filled with excessive amounts of elastinophilic, polymorphic fibers and hyperplastic adipose tissue. 2 This suggestion primarily bases on the early reports of higher prevalence of EFD particularly among individuals who perform hard manual labor. Publications in the following years, however, have reported EFD to be seen in individuals of other types of professions, and even in housewives, although more prevalent in some specific professions. 3 Another aspect that has been demonstrated over the years is the female predilection of EFD, with a majority being over 50 years of age. In our case presentation, we would like to draw attention to the possible correlation between hypermastia and EFD based on a patient who presented to our clinic with large breasts and was diagnosed with bilateral EFD. CASE PRESENTATION A 52-year old housewife presented to our clinic with complaints of large breasts, rash and bad smell underneath the breasts between the folds of skin, as well as pain and swelling in her back. The pain increased when she moved her arm. She had received long-term physiotherapy for her back and shoulder pain. Physical examination showed that her breasts were asymmetrically positioned on the 154 www.turkjplastsurg.org Correspondence Author: Dr. Mustafa Keskin E-mail: mkeskin@medipol.edu.tr Received: 17.08.2016 Accepted: 18.11.2016 Cite this article as: Keskin İ, Kolbaşı B, Akhan A, Çelik H, Hancı M, Keskin M.Possible Relationship Between Bilateral Elastofibroma Dorsi and Hypermastia. Turk J Plast Surg 2017; 25(3): 154-158. Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.