Ye Weihua, Zhu Guanghui, Liu Zheng
Orthopedic Department, Hunan Provincial Key Laboratory of Pediatric Orthopedics, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
Front Pediatr. 2025 Jul 2;13:1454139. doi: 10.3389/fped.2025.1454139. eCollection 2025.
To report a rare case of costal osteochondroma resulting in spinal cord compression in a 5-year-old patient, and to review the existing literature on costal osteochondromas.
A retrospective review was conducted on a case involving a 5-year-old male patient with hereditary multiple exostoses (HME), presenting with acute paraparesis due to a costal osteochondroma. The tumor's origin within the rib, associated myelopathic symptoms, and extensive erosion and fusion of vertebral elements were notable. The patient underwent total laminectomy, resection of the tumor, and thoracic fixation and fusion. A comprehensive literature review was performed using the keywords "Rib Osteochondroma" and "Spinal cord compression" to search the PubMed database.
A dumbbell-shaped bony tumor originating from the left seventh rib at the costovertebral junction was identified, causing intraspinal and extraforaminal mass effect and spinal cord compression. Surgical intervention included total laminectomy and tumor excision, followed by thoracic fixation and fusion. Histopathological analysis confirmed the diagnosis of osteochondroma. Postoperative recovery was uneventful, with significant improvement in neurological symptoms and complete resolution of lower extremity weakness at the ten-month follow-up. A mere nine cases of such presentation have been documented in the corpus of English-language literature.
This case highlights the rarity and clinical significance of costal osteochondromas causing spinal cord compression, particularly in a young pediatric patient. Early recognition and surgical intervention are crucial for favorable outcomes. Comprehensive imaging and careful surgical planning are essential to ensure complete tumor excision and maintain spinal stability.
报告一例罕见的肋软骨瘤导致一名5岁患者脊髓受压的病例，并回顾有关肋软骨瘤的现有文献。
对一例患有遗传性多发性骨软骨瘤（HME）的5岁男性患者进行回顾性研究，该患者因肋软骨瘤出现急性双下肢轻瘫。肿瘤起源于肋骨、相关的脊髓病症状以及椎体广泛侵蚀和融合值得注意。患者接受了全椎板切除术、肿瘤切除术以及胸椎固定融合术。使用关键词“肋骨软骨瘤”和“脊髓受压”对PubMed数据库进行全面的文献检索。
发现一个哑铃形骨肿瘤起源于左第七肋肋椎关节处，导致椎管内和椎间孔外肿块效应及脊髓受压。手术干预包括全椎板切除术和肿瘤切除术，随后进行胸椎固定融合术。组织病理学分析确诊为软骨瘤。术后恢复顺利，在十个月的随访中神经症状有显著改善，下肢无力完全消失。英文文献中仅记录了9例这种表现的病例。
本病例突出了导致脊髓受压的肋软骨瘤的罕见性和临床意义，尤其是在年轻儿科患者中。早期识别和手术干预对于取得良好结果至关重要。全面的影像学检查和仔细的手术规划对于确保肿瘤完全切除和维持脊柱稳定性至关重要。
