Alnassar Abdulaziz Sami
Dar Al Uloom University, Al Falah, Riyadh 13314, Saudi Arabia.
Int J Surg Case Rep. 2021 Apr;81:105762. doi: 10.1016/j.ijscr.2021.105762. Epub 2021 Mar 14.
Rib osteochondromas are rare genetic disorders, which can present as bony exostosis causing compression, impingement and damage to surrounding vessels, organs and structures within the thoracic cavity. The objective of this study was to clearly describe a rare presentation of rib osteochondromas in a pediatric patient along with managing techniques.
A 9-year-old girl was admitted to the hospital due to shortness of breath on exertion. Physical examination did not reveal any abnormalities except for small bony projections over the left 5th rib. Computed tomography (CT) scan showed a bony lesion on the left fifth rib causing cardiac compression. Video-assisted thoracoscopy (VAT) was done, which showed a bony exostosis compressing the left ventricle, the lesion was resected without any complications. Final pathology confirmed the diagnosis of osteochondroma measuring 2.0 cm × 2.0 cm × 1.5 cm, along with a thickness of 0.4 cm. Post-operative recovery was well, with no morbidities and the patient was discharged without any complications. On the post-operative follow up, the patient showed significant improvement in her symptoms.
Our reported case is a rare example of a solitary costal osteochondroma leading to serious complications because of its shape, size, and location. Previous reports have not addressed any significant traumatic event or impact prior to the occurrence of symptoms related to the cases, including the case of our patient. Cases of rib exostosis were surgically approached using different techniques most often through thoracotomy.
Rib osteochondromas are rare benign bony lesions which can cause cardiac symptoms secondary to direct compression. They can be resected safely via video assisted thoracoscopy (VAT) or limited thoracotomy.
肋骨骨软骨瘤是一种罕见的遗传性疾病，可表现为骨外生骨疣，对胸腔内的周围血管、器官和结构造成压迫、撞击和损害。本研究的目的是清晰描述一名儿科患者肋骨骨软骨瘤的罕见表现及处理技术。
一名9岁女孩因活动时气短入院。体格检查除左第5肋骨处有小的骨性突出外未发现任何异常。计算机断层扫描（CT）显示左第5肋骨有一骨病变，导致心脏受压。进行了电视辅助胸腔镜手术（VAT），结果显示一骨外生骨疣压迫左心室，该病变被切除，无任何并发症。最终病理确诊为骨软骨瘤，大小为2.0厘米×2.0厘米×1.5厘米，厚度为0.4厘米。术后恢复良好，无并发症，患者出院时无任何不适。术后随访时，患者症状有显著改善。
我们报告的病例是一个罕见的孤立性肋骨骨软骨瘤因形状、大小和位置导致严重并发症的例子。既往报告未提及在出现与病例相关的症状之前有任何重大创伤事件或撞击，包括我们患者的病例。肋骨外生骨疣病例的手术处理大多采用不同技术，通常是通过开胸手术。
肋骨骨软骨瘤是罕见的良性骨病变，可因直接压迫导致心脏症状。可通过电视辅助胸腔镜手术（VAT）或有限开胸手术安全切除。
