Nassereddine Hussein, Larousserie Frédérique, Campagna Raphaël, Castier Yves, Couvelard Anne, Choudat Laurence, Sannier Aurélie
1 Bichat Hospital, AP-HP, Paris, France.
2 Paris Descartes University, Paris, France.
Int J Surg Pathol. 2017 Oct;25(7):640-643. doi: 10.1177/1066896917712455. Epub 2017 Jun 4.
Posttraumatic fibro-osseous lesion (PTFOL) is a rare lesion that typically affects the ribs and is probably a posttraumatic reactive process. Because PTFOL is often misdiagnosed as fibrous dysplasia, osteoid osteoma, benign fibrous histiocytoma or rib metastases, chest wall resection, leading to a significant morbidity, is the main treatment modality. We report the case of a 30-year-old male patient with no history of previous trauma presenting with chest pain. Computed tomography scan showed an eighth left rib well-defined ovoid and hypodense lesion with circumferential sclerotic margin and no cortical breakthrough. Posterolateral thoracotomy was performed and a histological diagnosis of xanthomatous posttraumatic fibro-osseous lesion of the rib was made. PTFOL is a benign lesion that should be recognized to avoid unnecessary surgical treatment and complications. We provide a summary of clinical, histopathological, and radiological aspects of PTFOL and discuss differential diagnoses.
创伤后纤维骨性病变（PTFOL）是一种罕见病变，通常累及肋骨，可能是一种创伤后反应性过程。由于PTFOL常被误诊为骨纤维异常增殖症、骨样骨瘤、良性纤维组织细胞瘤或肋骨转移瘤，导致严重并发症的胸壁切除术是主要治疗方式。我们报告一例30岁男性患者，既往无创伤史，现出现胸痛。计算机断层扫描显示左第八肋骨有边界清晰的椭圆形低密度病变，边缘有环状硬化，无皮质突破。行后外侧开胸手术，组织学诊断为肋骨黄色瘤样创伤后纤维骨性病变。PTFOL是一种良性病变，应予以认识以避免不必要的手术治疗及并发症。我们总结了PTFOL的临床、组织病理学和放射学特征并讨论鉴别诊断。
