Bilateral Peri-Scapular and Gluteal Elastofibromas: A Report of an Incidental Finding During Oncologic Follow-Up Imaging

Elastofibroma is a benign soft-tissue tumor, typically located in the deep subscapular region. While bilateral dorsal elastofibromas are relatively common, the occurrence of multiple lesions involving distinct anatomical regions, particularly simultaneous involvement of the peri-scapular and gluteal areas, remains exceptionally rare. We report the case of a 64-year-old female patient undergoing oncologic surveillance for metastatic colorectal adenocarcinoma. During follow-up computed tomography (CT), incidental bilateral soft-tissue masses were identified adjacent to the serratus anterior muscles (peri-scapular) and within the gluteus medius muscles (gluteal regions). These lesions were asymptomatic and exhibited imaging features characteristic of elastofibromas, allowing for diagnosis without histologic confirmation. Stability of both gluteal and peri-scapular lesions was demonstrated on imaging follow-up. No specific treatment was required for these benign findings. This case highlights the exceptional rarity of concomitant bilateral elastofibromas involving both the peri-scapular and gluteal regions, particularly when incidentally discovered during oncologic follow-up. Vigilant radiologic assessment, with recognition of characteristic features even in atypical distributions, is essential to avoid misdiagnosis and unnecessary interventions, particularly in complex clinical settings.