Elastofibroma is a rare soft tissue benign fibrous proliferation that characteristically occurs in periscapular localization, particularly in females, with typical morphological features consisting of an admixture of collagen and abnormal elastic fibers. Here we report an unusual and recently described variant with unclear origin, showing the presence of abundant mature fat tissue, named 'elastofibrolipoma'.

Case: A 48-year-old female patient, who increasingly suffered from shoulder pain for 2 years, was admitted to our hospital. Physical examination revealed a localized, mobile mass of 5x5 cm on the back, in the right subscapular area. The T1 and T2 weighted MRI examination of the mass showed a localized heterogeneous mass 55x60 mm adjacent to the right scapula. Subsequently, the mass was excised.

Macroscopic examination of the mass revealed an encapsulated mass of 55x65 mm with regular borders, yellow-brown in color, consisting of mature adipose tissue of yellow color, centrally and peripherally, with a flesh-colored elastic consistency among the solid areas. Microscopic examination showed the lesions with a thin fibrous capsule containing a large number of eosinophilic globules, elastic fibers (E. Vangieson staining) and collagen mixed tapes and mature adipose tissue, centrally and peripherally. Depending on these findings and the literature cases, the lesions were diagnosed as elastofibrolipoma.

Conclusion: Elastofibrolipoma is a rare entity. On microscopic examination this entity must keep in mind and it is important to distinguish it from other lipomatous and fibromatous lesions.