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Pan R, Lu X, Wang Z, Duan L, Cao D. Hemothorax caused by costal exostosis injuring diaphragm: a case report and literature review. J Cardiothorac Surg 2022; 17:230. [PMID: 36068632 PMCID: PMC9450418 DOI: 10.1186/s13019-022-01984-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Osteochondromas, also known as exostoses, are the most common benign tumors of bone and can be classified into isolated and multiple osteochondromas. A great majority of osteochondromas is asymptomatic, painless, slow-growing mass, and incidentally found. However, osteochondromas occurring in adolescence or in adult patients can grow in size and become symptomatic as a result of mechanical irritation of the surrounding soft tissues or peripheral nerves, spinal cord compression, or vascular injury. Case presentation We present a case of a 13-year-old girl with spontaneous hemothorax, the cause of which was identified by limited thoracotomy with the aid of video-assisted thoracic surgery to be bleeding from a diaphragmatic laceration incurred by a costal exostosis on the left sixth rib. Preoperative chest computed tomography (CT) depicted a bony projection arising from the rib and bloody effusion in the intrathoracic cavity, but was unable to discern the bleeding cause from the lung or the diaphragm. This case will highlight our awareness that costal exostosis possibly results in bloody pleural effusion. Meanwhile, English literatures about solitary costal exostosis associated with hemothorax were searched in PubMed and nineteen case reports were obtained. Combined our present case with available literature, a comprehensive understanding of this rare disease entity will further be strengthened. Conclusions Injury to the diaphragm is the primary cause of hemothorax caused by costal osteochondroma, including the present case. Thoracic CT scan can help establish a diagnosis of preoperative diagnosis of costal osteochondroma. Surgical intervention should be considered for those patients with symptomatic osteochondroma of the rib. Combined with our case and literature, prophylactic surgical removal of intrathoracic exostosis should be advocated even in asymptomatic patients with the presentation of an inward bony spiculation.
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Affiliation(s)
- Ruonan Pan
- Department of Radiology, the First Hospital of Jilin University, No. 71 of Xinmin Street, Changchun, Jilin, 130021, China
| | - Xiaoqian Lu
- Department of Radiology, the First Hospital of Jilin University, No. 71 of Xinmin Street, Changchun, Jilin, 130021, China
| | - Zhijun Wang
- Pediatric Surgery, the First Hospital of Jilin University, Changchun, 130021, China
| | - Lijun Duan
- Department of Radiology, the First Hospital of Jilin University, No. 71 of Xinmin Street, Changchun, Jilin, 130021, China
| | - Dianbo Cao
- Department of Radiology, the First Hospital of Jilin University, No. 71 of Xinmin Street, Changchun, Jilin, 130021, China.
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Nakamura K, Asanuma K, Shimamoto A, Kaneda S, Yoshida K, Matsuyama Y, Hagi T, Nakamura T, Takao M, Sudo A. Spontaneous pneumothorax in a 17-year-old male patient with multiple exostoses: A case report and review of the literature. World J Orthop 2021; 12:945-953. [PMID: 34888155 PMCID: PMC8613679 DOI: 10.5312/wjo.v12.i11.945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/07/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiple exostoses generally develop in the first decade of life. They most frequently arise from the distal femur, proximal tibia, fibula, and proximal humerus. Costal exostoses are rare, contributing to 1%–2% of all exostoses in hereditary multiple exostoses (HME). They are usually asymptomatic, but a few cases have resulted in severe thoracic injuries. Pneumothorax caused by costal exostoses is rare, with only 13 previously reported cases. We report a new case of pneumothorax caused by costal exostoses.
CASE SUMMARY A 17-year-old male with HME underwent surgery for removal of exostoses around his right knee. Four months following the operation, he felt chest pain when he was playing the trumpet; however, he did not stop playing for a week. He was referred to our hospital with a chief complaint of chest pain. The computed tomography (CT) scan revealed right pneumothorax and multiple exostoses in his right ribs. The CT scan also revealed visceral pleura thickness and damaged lung tissues facing the exostosis of the seventh rib. We diagnosed that exostosis of the seventh rib induced pneumothorax. Costal exostosis resection was performed by video-assisted thoracoscopic surgery (VATS) 2 wk after the onset. The patient’s postoperative course was uneventful, and there was no recurrence of pneumothorax for 2 years.
CONCLUSION Costal exostoses causing thoracic injuries should be resected regardless of age. VATS must be considered in cases with apparently benign and relatively small exostoses or HME.
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Affiliation(s)
- Koichi Nakamura
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Kunihiro Asanuma
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Akira Shimamoto
- Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Shinji Kaneda
- Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Keisuke Yoshida
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Yumi Matsuyama
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Tomohito Hagi
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Tomoki Nakamura
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Motoshi Takao
- Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
| | - Akihiro Sudo
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Mie Prefecture, Japan
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Mazza D, Fabbri M, Calderaro C, Iorio C, Labianca L, Poggi C, Turturro F, Montanaro A, Ferretti A. Chest pain caused by multiple exostoses of the ribs: A case report and a review of literature. World J Orthop 2017; 8:436-440. [PMID: 28567348 PMCID: PMC5434351 DOI: 10.5312/wjo.v8.i5.436] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/19/2016] [Accepted: 03/02/2017] [Indexed: 02/06/2023] Open
Abstract
The aim of this paper is to report an exceptional case of multiple internal exostoses of the ribs in a young patient affected by multiple hereditary exostoses (MHE) coming to our observation for chest pain as the only symptom of an intra-thoracic localization. A 16 years old patient with familiar history of MHE came to our observation complaining a left-sided chest pain. This pain had increased in the last months with no correlation to a traumatic event. The computed tomography (CT) scan revealed the presence of three exostoses located on the left third, fourth and sixth ribs, all protruding into the thoracic cavity, directly in contact with visceral pleura. Moreover, the apex of the one located on the sixth rib revealed to be only 12 mm away from pericardium. Patient underwent video-assisted thoracoscopy with an additional 4-cm mini toracotomy approach. At the last 1-year follow-up, patient was very satisfied and no signs of recurrence or major complication had occured. In conclusion, chest pain could be the only symptom of an intra-thoracic exostoses localization, possibly leading to serious complications. Thoracic localization in MHE must be suspected when patients complain chest pain. A chest CT scan is indicated to confirm exostoses and to clarify relationship with surrounding structures. Video-assisted thoracoscopic surgery can be considered a valuable option for exostoses removal, alone or in addiction to a mini-thoracotomy approach, in order to reduce thoracotomy morbidity.
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Rupp M, Hardes J, Raschke MJ, Skwara A. Bilateral Scapulothoracic Osteochondromas in a Patient With Hereditary Multiple Exostosis: A Case Report and Review of the Literature. Orthop Rev (Pavia) 2016; 8:6501. [PMID: 27761218 PMCID: PMC5066108 DOI: 10.4081/or.2016.6501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/30/2016] [Accepted: 07/31/2016] [Indexed: 12/11/2022] Open
Abstract
Hereditary multiple exostosis (HME) is an autosomal dominant disorder characterized by two or more benign growing, cartilage capped tumors of long bones called osteochondromas. If abnormal growth and clinical symptoms of osteochondromas newly appear in adults, malignant transformation of the usually benign growing tumors should be suspected and diagnostic testing should be initiated. Against the background of hypothesized higher malignant transformation of osteochondromas into chondrosarcoma in individuals with shoulder exostoses, we report a case of bilateral scapulothoracic osteochondromas in a patient suffering from HME. A 60-year-old female with HME complained of chest pain while being hospitalized for bilateral femoral fractures. A computed tomography scan of the chest was performed to rule out pulmonary embolism. However, bilateral osteochondromas in the scapulothoracic spaces were detected. Due to absence of radiographic evidences for malignant transformation in the patient, invasive diagnostic procedures such as biopsy and histological examination were recommended in order to exclude malignant transformation of both osteochondromas. Physicians should be aware that patients with HME who present with shoulder pain should be examined for osteochondromas in the scapulothoracic space. Due to possible sarcomatous transformation, regular follow-ups are necessary for adolescents and adults.
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Affiliation(s)
- Markus Rupp
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Giessen and Harburg, Campus Giessen
- Department of Trauma-, Hand- and Reconstructive Surgery, Muenster University Hospital
| | - Jendrik Hardes
- Clinic for General Orthopedics and Tumor Orthopedics, Muenster University Hospital
| | - Michael J. Raschke
- Department of Trauma-, Hand- and Reconstructive Surgery, Muenster University Hospital
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Kadu VV, Saindane KA, Goghate N, Goghate N. Osteochondroma of the Rib: a rare radiological apeareance. J Orthop Case Rep 2016; 5:62-4. [PMID: 27299024 PMCID: PMC4719358 DOI: 10.13107/jocr.2250-0685.258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: Osteochondromas (exostosis) are the most common neoplasm of bone and arise from the metaphysis of bones. Tumors of the chest wall comprise approximately 2% of all tumors of the body and may be primary or metastatic, benign or malignant. Osteochondroma is a common bone tumor but a rare tumor in the rib. It is often asymptomatic and observed incidentally. The tumors typically begin to grow before puberty and continue until bone maturation is reached. Surgery is required in childhood if these lesions are painful or disfiguring, while those arising in adulthood should always be resected. Case Report: 9 yr old boy presented to OPD with swelling over right chest. Radiograph showed bony outgrowth on the lateral aspect of the 6th rib. The patient was kept under closed observation and was treated conservatively. Three years follow-up didn’t show any increase in the size of the swelling and the patient did not have any complaints. Conclusion: Though various studies have shown that the surgical resection of osteochondroma is necessary to avoid further complications of Haemothorax, pneumothorax or intercostal neuralgia, we concluded that osteochondroma of the ribs can even be conserved if not associated with complications and patient does not need to undergo unnecessary surgery.
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Affiliation(s)
- Vikram V Kadu
- ACPM Medical College, Dhule - 424001, Maharashtra. India
| | - K A Saindane
- ACPM Medical College, Dhule - 424001, Maharashtra. India
| | - Ninad Goghate
- ACPM Medical College, Dhule - 424001, Maharashtra. India
| | - Neha Goghate
- ACPM Medical College, Dhule - 424001, Maharashtra. India
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Dikici A, Bakan S, Kandemirli S, Sonmez S, Ersen E, Comunoglu N, Kantarci F. Suprascapular nerve compression due to rib osteochondroma: MR imaging features. Diagn Interv Imaging 2016; 97:109-11. [DOI: 10.1016/j.diii.2015.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 10/23/2022]
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Osteochondroma of the fifth rib resulting in recurrent hemothorax. Skeletal Radiol 2015; 44:1853-6. [PMID: 26424661 DOI: 10.1007/s00256-015-2257-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/10/2015] [Accepted: 09/14/2015] [Indexed: 02/02/2023]
Abstract
A 48-year-old man presented with recurrent spontaneous hemothoraces, which ultimately were found to be secondary to a pedunculated costal osteochondroma causing vascular injury. After initially undergoing endovascular coil embolization, he ultimately required segmental rib resection containing the offending lesion for definite treatment. Although a few cases of symptomatic costal osteochondromas have been reported in the literature, as far as we know, no previous reports have provided direct radiologic confirmation of active bleeding or the role of angiographic intervention. In this report, we highlight the importance of CT angiography in establishing a direct link between an osteochondroma and recurrent hemothorax. We also discuss the diagnostic imaging challenges associated with this condition and the use of a multidisciplinary treatment strategy involving both angiographic and operative management.
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Yoon JS, Kwon JB, Park CB, Suh JH. Costal exostoses as an unusual cause of spontaneous hemothorax. J Cardiothorac Surg 2015; 10:135. [PMID: 26506826 PMCID: PMC4624699 DOI: 10.1186/s13019-015-0342-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 10/19/2015] [Indexed: 11/19/2022] Open
Abstract
A 20-year-old male presented with chest pain lasting several days. A radiologic examination revealed pleural effusion in the right hemithorax. Video-assisted thoracoscopic surgery demonstrated a bleeding focus at the diaphragm caused by injury due to a costal exostosis.
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Affiliation(s)
- Jeong Seob Yoon
- Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, 56, Dongsu-Ro, Bupyeong-Gu, Incheon, 403-720, Republic of Korea.
| | - Jong Bum Kwon
- Department of Thoracic and Cardiovascular Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 64, Daeheong-Ro, Jung-Gu, Daejeon, 34943, Republic of Korea.
| | - Chan Beom Park
- Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, 56, Dongsu-Ro, Bupyeong-Gu, Incheon, 403-720, Republic of Korea.
| | - Jong Hui Suh
- Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, 56, Dongsu-Ro, Bupyeong-Gu, Incheon, 403-720, Republic of Korea.
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Abstract
BACKGROUND Chest wall osteochondroma is a rare tumor in children. Even though the potential for malignant transformation or serious intrathoracic complications is low, it has led some centers to advocate surgical management of these bony tumors. We present our experience of the surgical management of costal osteochondromata. METHODS Between January 1, 2006 and November 1, 2012 we saw 854 patients with solitary or multiple exostoses in our clinics. By reviewing our billing lists we found 7 children who had surgical management of chest wall osteochondromata. The indications for surgery were pain (3 patients), excision for confirmation of diagnosis (2 patients), recurrent pneumothorax (1 patient), and malignancy (1 patient). RESULTS All patients made a good postoperative recovery with a median hospital stay of 1.8 days (range, 0 to 4 d). There was no recurrence of exostosis on follow-up (range, 8 mo to 2.6 y). One patient required surgery for excision of another chest wall osteochondroma at an adjacent location. No patient reported scar-related pain symptoms. No malignant transformation or intrathoracic complications occurred. We found ribs as the first site of presentation of multiple hereditary exostoses in 2 young patients. CONCLUSIONS Surgical management of thoracic osteochondroma, with excision for painful, symptomatic, malignant lesions or lesions adjudged to be at risk of intrathoracic complications, yields good outcomes in terms of symptom control, establishing histologic diagnosis, and prevention of thoracic complications. LEVEL OF EVIDENCE Level IV-case series.
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Boyacioğlu K, Kayalar N, Sarioğlu S, Yildizhan I, Mert B, Erentuğ V. Popliteal artery pseudoaneurysm associated with solitary osteochondromatosis. Vascular 2013; 22:286-9. [PMID: 23929420 DOI: 10.1177/1708538113486784] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Osteochondroma is the most common benign tumor of the bone, seen mostly during adolescence. In the current study, we report a 19-year-old male patient with a two-week history of pain and swelling of the medial side of his right thigh just above the knee without any trauma. CT angiography revealed a popliteal artery pseudoaneurysm and its close relationship with a femoral osteochondroma. Surgical repair consisted of repair of pseudoaneurysm and removal of osteochondroma. In young patients, a non-traumatic pseudoaneurysm of distal femoral artery may be a complication of an osteochondroma and this treatable pathology should be looked for to prevent recurrence.
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Affiliation(s)
- Kamil Boyacioğlu
- Bagcilar Training and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
| | - Nihan Kayalar
- Bagcilar Training and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
| | - Seçkin Sarioğlu
- Bagcilar Training and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
| | - Ibrahim Yildizhan
- Bagcilar Training and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
| | - Bülent Mert
- Bagcilar Training and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
| | - Vedat Erentuğ
- Bagcilar Training and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
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Oudyi M, David M, Blondel B, Bosdure E, Gorincour G, Launay F, Dubus JC. Hémothorax et maladie exostosante multiple héréditaire chez un enfant de 9 ans. Arch Pediatr 2011; 18:170-5. [PMID: 21190817 DOI: 10.1016/j.arcped.2010.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 07/07/2010] [Accepted: 11/25/2010] [Indexed: 01/01/2023]
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Khosla A, Parry RL. Costal osteochondroma causing pneumothorax in an adolescent: a case report and review of the literature. J Pediatr Surg 2010; 45:2250-3. [PMID: 21034955 DOI: 10.1016/j.jpedsurg.2010.06.045] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 06/23/2010] [Accepted: 06/25/2010] [Indexed: 02/08/2023]
Abstract
Costal osteochondroma is a rare but important condition to recognize because of the possibility of serious consequences if not diagnosed and treated promptly. Patients can present with numerous complications, including hemothorax, pneumothorax, nervous or vascular impingement, and fracture. We report the case of a 17-year-old adolescent boy who presented to the pediatrician with intermittent shortness of breath and pleuritic chest pain. A chest x-ray demonstrated a left-sided pneumothorax and triangular opacity in the left chest. A computed tomographic scan of the chest revealed the cause to be a costal exostosis of the anterior fifth rib. The lesion was excised using video-assisted thoracoscopic surgery, which has become an increasingly popular method for treating these lesions, causing significantly less morbidity and allowing for a faster recovery than a major thoracotomy.
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Affiliation(s)
- Arjun Khosla
- Division of Pediatric Surgery, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA.
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Orawczyk T, Kuczmik W, Kazibudzki M, Ludyga T, Cwik P, Ziaja K. Popliteal Pseudoaneurysm as a Rare Complication of a Solitary Tibial Osteochondroma. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ejvsextra.2006.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Huang HR, Lin TY, Wong KS. Costal exostosis presenting with hemothorax: report of one case. Eur J Pediatr 2006; 165:342-3. [PMID: 16435130 DOI: 10.1007/s00431-005-0060-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Accepted: 11/16/2005] [Indexed: 02/07/2023]
Affiliation(s)
- Hsuan-Rong Huang
- Department of Pediatrics, Chang Gung Children's Hospital and University, 5, Fu-Hsin Street, Kueishan, Taoyuan, Republic of China
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Pham-Duc ML, Reix P, Mure PY, Pracros JP, Moreux N, Bellon G. Hemothorax: an unusual complication of costal exostosis. J Pediatr Surg 2005; 40:e55-7. [PMID: 16291144 DOI: 10.1016/j.jpedsurg.2005.07.060] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We report a case of a spontaneous hemothorax in a 15-year-old girl because of costal exostosis. This possibly may have been provoked by a nontraumatic rupture of markedly dilated pleural vessels because of long-standing friction between the exostosis and the pleura. The authors conclude that exostosis of the rib is a rare cause of hemothorax in children and should be considered among possible etiologies in diagnosis.
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Affiliation(s)
- Mai Linh Pham-Duc
- Department of Pediatrics, Pulmonology, Allergology and Cystic Fibrosis, Hôpital Debrousse, 69322 Lyon, France
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Cowles RA, Rowe DH, Arkovitz MS. Hereditary multiple exostoses of the ribs: an unusual cause of hemothorax and pericardial effusion. J Pediatr Surg 2005; 40:1197-200. [PMID: 16034772 DOI: 10.1016/j.jpedsurg.2005.03.064] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
A 6-year-old girl with hereditary multiple exostoses presented with spontaneous hemothorax and pericardial effusion. Chest computed tomographic scan showed left-sided costal exostoses protruding into the left side of the chest. She underwent successful thoracoscopic resection of 3 left rib exostoses and made a full recovery. This report illustrates this rare clinical scenario and reviews the previously published reports of this complication of costal exostoses.
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Affiliation(s)
- Robert A Cowles
- Division of Pediatric Surgery, The Children's Hospital of New York-Presbyterian, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
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Jin W, Hyun SY, Ryoo E, Lim YS, Kim JK. Costal osteochondroma presenting as haemothorax and diaphragmatic laceration. Pediatr Radiol 2005; 35:706-9. [PMID: 15806405 DOI: 10.1007/s00247-005-1407-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2004] [Accepted: 12/13/2004] [Indexed: 12/19/2022]
Abstract
We report the unusual case of an 11-year-old girl who suffered a large haemothorax and lacerated left hemidiaphragm because of a costal osteochondroma arising from the left sixth rib near the costochondral junction. Surgical excision of the osteochondroma was performed and the lacerated diaphragm was repaired.
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Affiliation(s)
- Wook Jin
- Department of Diagnostic Radiology, Gil Medical Centre, Gachon Medical School, 1198 Guweol-dong, Namdong-gu, Incheon, South Korea.
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Abstract
We report two cases of unusual presentation of rib exostosis. The first patient presented acutely with hemorrhagic shock due to massive hemothorax, and the second patient presented with repetitive chest infection complicated by empyema. In both patients, preoperative computed tomographic (CT) scan of the chest revealed rib exostoses, necessitating thoracotomy and rib resection.
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Affiliation(s)
- Waseem M Hajjar
- Department of Surgery, Division of Thoracic Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia
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Abstract
This report describes a 21-year-old man who presented with pericardial hemorrhage due to a puncture wound of the pericardium by an inward-facing exostosis of the left fifth rib.
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Affiliation(s)
- Ichiro Fukai
- The Second Department of Surgery, Nagoya City University Medical School, Nagoya, Japan.
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Abstract
Most osteochondromas are asymptomatic and incidental with typical radiographic characteristics. When symptomatic, complications due to space-occupying effects, mechanical deformity, or malignant transformation are usually the underlying causes. This article addresses the imaging strategy for their identification and evaluation.
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Affiliation(s)
- K C Y Lee
- Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK
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Trujillo-Santos AJ, Valdés-Solís P, Fernández-Guerra J, García de Lucas MD. [Spontaneous hemothorax secondary to fracture of solitary costal exostosis]. Med Clin (Barc) 2000; 114:718-9. [PMID: 10916797 DOI: 10.1016/s0025-7753(00)71412-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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