Rib Tumor Research Articles

Impact of pleural reconstruction on postoperative outcomes in rib tumor resection: a decade-long retrospective study.

This study aims to evaluate the effects of pleural reconstruction during rib compartment tumor resection surgery on postoperative outcomes, including drainage volume, drainage duration, hospital stay, complications, and pain control. A retrospective analysis was conducted on 142 patients who underwent rib compartment tumor resection surgery at Beijing Jishuitan Hospital from January 2013 to October 2023. The patients were divided into two groups: those who received pleural reconstruction and those who did not. Data were collected from hospital medical records and outpatient care records, focusing on postoperative drainage volume, total drainage time, length of hospital stay, complications, and pain scores. Continuous variables were compared using t-tests or nonparametric tests, while categorical variables were analyzed using chi-square tests or Fisher's exact tests. The analysis showed no significant differences between the two groups in terms of postoperative complications and pain thresholds. However, patients who underwent pleural reconstruction had significantly lower postoperative drainage volume (937.74 ± 855.97 vs. 1,595.26 ± 1,054.50 ml, p < 0.05), shorter drainage duration (5.5 ± 2.39 vs. 8.43 ± 2.87 days, p < 0.05), and reduced length of hospital stay (7.32 ± 3.30 vs. 10.99 ± 6.83 days, p < 0.05). Pleural reconstruction during rib compartment tumor resection surgery reduces postoperative drainage volume, drainage duration, and hospital stay without increasing complications or short-term pain. Further large-scale studies are recommended to validate these findings.

Rib Hemangiomas: Intriguing Findings from a Systematic Review of Rare Thoracic Tumors.

Background: Bone hemangiomas are rare benign vascular tumors, comprising less than 1% of all bone tumors. They are predominantly found in the vertebral body or skull; rib hemangiomas are particularly rare and are often misdiagnosed as malignant tumors. Given the high malignancy rate of primary rib tumors, understanding rib hemangiomas is crucial to avoid misdiagnosis. Methods: A systematic review was conducted according to PRISMA standards. A comprehensive literature search was performed in PubMed, EMBASE, Web of Science, and Scopus. Data on patient demographics, tumor characteristics, and clinical presentation were analyzed using STATA/SE 17. Results: From 306 articles, 40 studies including 43 patients met the inclusion criteria. Rib hemangiomas showed a bimodal age distribution, with peaks in patients younger than 30 years (mean age 21.43 ± 5.60 years) and ≥30 years (mean age 59.96 ± 9.70 years). Females were more affected (62.79%) than males (37.21%), with a ratio of 1.69:1. The tumors were most frequently located in mid-thoracic ribs (4-8) and predominantly on the left side of the thorax. The mean tumor size was 7.27 cm, with 76.19% exhibiting osteolytic changes. Clinically, 63.41% of cases were asymptomatic, while symptomatic cases mainly presented with pain. Conclusions: Rib hemangiomas, though rare, should be considered in the differential diagnosis of thoracic tumors. They present as well-demarcated lytic lesions with distinct imaging features, and they typically require complete surgical excision, which may be aided with preoperative embolization. Their accurate diagnosis involves a combination of radiologic and clinical evaluation. Further studies are needed to understand the disease's pathophysiology and to refine diagnostic and treatment protocols.

Surgical treatment and outcome of primary rib tumours in cats: eight cases (2016-2023).

To describe the clinical features and oncologic outcome for cats with primary rib tumours. Medical records for cats with surgically treated primary rib tumours from six veterinary referral centres were reviewed. Signalment, preoperative clinical signs, reconstruction technique, and surgical and oncologic outcome were retrieved from medical records or by telephone interview with owners and/or referring veterinarians. Of the eight cats with primary rib tumours, three had hemangiosarcoma, two had osteosarcoma and one cat each had chondrosarcoma, osteochondroma and osteoma. The size of the primary rib mass ranged from 2 × 2 × 1.6 cm to 9 × 7 × 7.5 cm. Three minor and one major complication developed during the immediate post-operative period. Surgery consisted of thoracic wall resection in all cats. All animals survived the procedure and the median time to discharge was 3 days. The survival time for benign tumours was 150 (case 5) and 466 (case 4) days, while for malignant tumours ranged from 105 to 550 days (cases 1 to 3, cases 6 to 8). Hemangiosarcoma and osteosarcoma were the most represented primary rib tumours in this cohort of cats. Wide surgical excision and adjuvant chemotherapy is recommended for cats with hemangiosarcoma and osteosarcoma, but the prognosis remains guarded. Prognosis appears to be fair for the other tumour types.

Rib tumors: A ten-year institutional study

Objectives The primary aim of this study was to study the demography and frequency distribution of the various rib tumors. The treatment modality offered and patient outcomes were also recorded wherever available. Material and Methods A ten year data was retrieved from the hospital registry from 2011-2021. Inclusion criteria were all patients with any tumors in the rib. Those patients who did not have a histological diagnosis and those having a chest wall mass and secondary involvement of the ribs were excluded. Results Out of 72 cases of rib tumors, 25 were diagnosed as Ewing Sarcoma, 22 Chondrosarcoma cases, 10 Multiple myeloma/plasmacytoma cases, 9 Osteosarcoma cases, rest 1 case each of Non Hodgkin Lymphoma, Brown tumor, Enchondroma, Osteochondroma, Clear cell sarcoma and metastases. Conclusion In this study the most common primary malignant tumor of the ribs in adults was Chondrosarcoma (41.1%) and in pediatric &amp; young adolescent age group (upto 18yrs) it was Ewing sarcoma (76.1%)

Resection of the entire first rib for giant osteochondroma by trans manubrial approach: a case report and review of the literature

BackgroundFirst rib tumors are extremely rare. Its compression of neurovascularity can easily lead to severe complications such as thoracic outlet syndrome, so early surgical resection is crucial. However, there is no standardized approach to surgery.Case presentationA previously healthy 18-year-old Chinese male undergoes a chest computed tomography (CT) scan that incidentally reveals a raised calcified mass on the right first rib, which is most likely an osteochondroma when combined with magnetic resonance imaging (MRI). We achieved excellent results with resection and thoracic reconstruction by adopting an inverse L-shaped incision in the anterior chest and a longitudinal split of the sternum.ConclusionsOur practice provides great reference for the surgical management of first rib tumors.

Localised plasmacytoma presenting as right chest wall swelling

Development of any swelling in the right lower chest wall or right upper abdomen is an unusual presentation. Hence the localisation of the origin of swelling becomes difficult to ascertain through clinical examination alone. Accurate diagnosis requires detailed investigation and ruling out of differentials one by one. We would like to share one such case of a patient presenting to surgery OPD with complaint of swelling in the lateral aspect of right chest wall which on investigations turned out to be a rib tumour arising from the bone marrow. Lady of age 57 years presented to us with h/o swelling in lateral aspect of right chest wall which gradually increased in size over 3 years and associated with pain for last 5 months. On exam an oval swelling of size 8×5 cm seen in lateral wall of right lower chest wall. On detailed investigations, the swelling was diagnosed as a plasma cell tumour of right 8th rib. Any chest wall or abdominal swelling needs detailed evaluation before proceeding for surgical intervention. It is important to keep various differential diagnosis in mind considering clinical factors and site of swelling to make an accurate diagnosis.

Conventional chondrosarcoma of the rib cage and sternum: clinicopathological and molecular analysis of 27 patients treated at a single institution

Conventional chondrosarcoma of the chest wall is rare, accounting for 15% of cases. Our purpose was to document clinicopathological, imaging and outcome results from a novel set of chest wall chondrosarcomas, and to analyze for IDH mutations and novel molecular alterations. Gross and microscopic pathology, imaging and clinical charts were reviewed. Targeted next-generation sequencing was performed to identify somatic mutations and copy number alterations. The cohort consisted of 27 patients: 16 men and 11 women (mean age 51 years; range 23-76). Palpable mass was the most common presentation. Five were discovered incidentally. Among 20 tumors with complete imaging, 15 arose from a rib and 5 from the sternum. Seven rib tumors were central/intramedullary, 5 were periosteal, 2 were secondary peripheral chondrosarcomas, and one was indeterminate. Among sternal tumors, 4 were central/intramedullary and one was periosteal. Half the periosteal tumors arose from the costochondral junctional cartilage (CCJ). Periosteal chondrosarcomas were sometimes mistaken for extraskeletal masses on initial clinical or radiological examinations. Fifty-nine percent of all tumors were grade 1 and 41% were grade 2. None were dedifferentiated chondrosarcomas. Heterozygous IDH1 mutation was detected in one tumor and heterozygous RAD50 mutation in another. Local recurrence(s) happened in 41% and metastasis in 41%. Grade had strong association with local recurrence (25% grade 1 vs. 64% grade 2 [P=.0447]), metastatic recurrence (19% grade 1 vs. 73% grade 2 [P=.0058]), and survival. Although chest wall chondrosarcomas share morphologic and molecular features with other chondrosarcomas, there is a much higher incidence of periosteal chondrosarcomas. IDH mutant tumors are uncommon. Early diagnosis and margin-negative resection is treatment of choice since chondrosarcomas are chemo- and radioresistant.

CT features of primary bone neoplasia of the thoracic wall in dogs.

Primary thoracic wall neoplasia is uncommon in dogs and the prognosis depends on tumor type. The aims of this retrospective, multi-center, observational study were to describe CT features of primary thoracic wall neoplasia in dogs and to test the hypothesis that CT features would differ among tumor types. Dogs with a diagnosis of primary thoracic wall bone neoplasia and thoracic CT study were included. CT findings recorded were as follows: dimensions, location, invasiveness, grade and type of mineral attenuation, periosteal reaction, contrast enhancement, and presence of presumed pulmonary metastases, pleural effusion, and sternal lymphadenopathy. Fifty-eight cases were included (54 ribs and four sternum). Fifty-six were malignant (sarcomas - SARC) and two were benign (chondromas - CHO). Out of the 56 malignant tumors, 41 had histological confirmation of the tumor type: 23 (56%) osteosarcomas (OSA), 10 (24%) chondrosarcomas (CSA), and eight (20%) hemangiosarcomas (HSA). The majority of rib tumors were right-sided (59%) and ventrally located (72%). Malignant masses showed severe invasiveness, mild/moderate contrast enhancement, and different grades of mineral attenuation. Sternal lymphadenopathy was significantly more frequent in dogs with OSA and HSA compared to dogs with CSA (p = 0.004 and p = 0.023). Dogs with HSA showed significantly lower mineral attenuation grades compared to dogs with OSA (p = 0.043). Primary thoracic wall bone neoplasias were more frequently arising from the ribs, with only a few cases of sternal masses. Findings can be used to help prioritize differential diagnoses for CT studies of dogs with thoracic wall neoplasia.

An Unusual Case of Cervical Rib Tumor Presenting as Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a complex clinical entity with a group of diverse disorders caused by multiple factors that compress the brachial plexus, subclavian artery, and subclavian vein. Among all the causes, a tumor in that region causing TOS is a very rare cause. Here, we present the case of a 21-year-old girl with right cervical rib osteoblastoma (OB) presenting as TOS, with direct compression of the brachial plexus and subclavian artery. OBs are rare primary bone tumors and origin from cervical bone is unheard. To our knowledge, this is the first case of a cervical rib OB mimicking as NTOS, and we share our experiences and challenges in managing this case more so due to the rarity of case and paucity of data in the literature.

A case report of robotic-assisted resection of large fibrous benign tumor of second rib

BackgroundSurgical resection is the most effective curative management of benign rib tumors and carries an excellent prognosis. Due to complex anatomy and narrow field, higher rib resection is technically demanding and requires extensive dissection.Case presentationWe report a case of second rib tumor resection performed transthoracic under Da Vinci robot assistance. A 32-year-old male complained about increasing pain in the left anterior chest wall. After 3D reconstruction of CT, it showed a well-circumscribed fusiform lesion with a multi-component structure. Measured 17 × 6 × 4 cm and extended into the chest cavity to the depth below the pectoralis minor muscle. The patient underwent robotic-assisted trans-thoracic second rib resection. At four weeks of outpatient follow-up, the patient reported no pain and uncomplicated wound healing.ConclusionThis minimally invasive approach offers optimal visualization and tissue manipulation while dramatically decreasing the possibility of collateral damage, hence ensuring fast function recovery. To the best of our knowledge, these kinds of procedures are rarely reported in detail.

Langerhans cell histiocytosis of the rib in an adult: A case report and review of the literature.

Introduction and importanceLangerhans cell histiocytosis (LCH) is a rare neoplastic hyperplasia with an unknown etiology. It is clinically rare for patients with solitary rib lesion and pathological fracture. In this article, we report a case of LCH in solitary involvement of rib and provide a review of the available literature.Case presentationA 24-year-old female patient complained of right chest and back pain for 10 days. CT showed a fracture in the right 6th rib. Findings on X-ray, and CT were suggestive of homogeneous osteolytic lesion of the right 6th rib. The rib tumor was then resected and the surrounding muscles and soft tissues were accordingly resected.Clinical discussionThe patient was diagnosed with pathological rib fracture, and the patient was pathologically diagnosed with LCH. After surgery, no local recurrence or distant metastasis was reported during the one-year follow-up.ConclusionsMost of the solitary tumorous lesions in rib in adults call for various differential diagnoses. Although single-site, single-system LCH of the rib is one of the rarest causes of bone tumor in adults, it can be treated successfully with surgical intervention. LCH should be considered in the diagnosis of an adult patient with a rib mass.

Benign rib tumors: a case series from tertiary care Centre of Nepal and review of literature.

Rib tumors are rare. They can present with wide varieties of symptoms and differentiating benign from malignant lesions is challenging. A careful history and supporting investigations can help to reach the definite diagnosis. Surgical resection is the treatment of choice with excellent prognosis. A total of four patients were operated for the management of rib tumors over a period of 5 years at our institution. All four were benign lesions and included simple bone cyst, fibrous dysplasia with aneurysmal bone cyst, aneurysmal bone cyst and enchondroma. There were three male and one female. None of them is having recurrence till now. Surgical resection is the treatment of choice for benign rib tumors as it provides diagnostic and curative treatment.

Rare chondroblastoma of the 6th left rib, video-assisted thoracoscopy resected: one case report and literature review

IntroductionChondroblastoma is a rare, benign locally but aggressive bone tumor. It accounts for < 1% of primary bony tumors, and mostly arises from long bones; the rib chondroblastoma is especial rare. Due to its rarity, there are no definitive or standard treatment guidelines.Case presentationA case of a 24-year-old male with a chondroblastoma located on the 6th posterior left rib. Computed tomography (CT) demonstrated a rib tumor that was a well-defined oval lesion of 20 mm × 18 mm, with lytic bone destruction. The imaging first diagnosis was Langerhans cell histiocytosis (LCH), a giant cell tumor, or other type of neoplasm. The whole tumor and a part of partial rib were resected by video-assisted thoracoscopy surgery (VATS). Pathological and immunohistochemical (IHC) examination made a diagnosis of chondroblastoma. Compared with traditional open thoracic surgery, VATS can achieve the same effects and cause less injury to patient. No postoperative adjuvant therapy was given, and had followed up 23 months after surgery, there was no recurrence or metastasis.ConclusionChondroblastoma has a risk of recurrence and metastasis, surgery plays an important role in the treatment of chondroblastoma, VATS can achieve the same outcome as traditional open thoracic surgery with less pain and lung function. Close follow-up is needed postoperative.

A case of successful ultrasound-guided paravertebral nerve block for rib tumor resection in a child

A case of successful ultrasound-guided paravertebral nerve block for rib tumor resection in a child

Langerhans cell histiocytosis of the rib presenting with pathological fracture: a case report

IntroductionLangerhans cell histiocytosis (LCH) is a rare neoplastic hyperplasia with an unknown etiology. It is clinically rare for patients with solitary rib lesion and pathological fracture; moreover, its diagnosis and treatment are quite difficult. The purpose of this study is to present a case for the pathogenesis, clinical features, imaging, and treatment of this disease.Case presentationA 52-year-old female patient complained of left chest pain for one week. CT showed a fracture in the left 5th rib. The rib tumor was then resected and the surrounding muscles and soft tissues were accordingly resected. The patient was diagnosed with pathological rib fracture, and the patient was pathologically diagnosed with LCH. After surgery, no local recurrence or distant metastasis was reported during the two-year follow-up.ConclusionsLCH should be treated by observation, chemotherapy, radiotherapy, or surgery, or using a combination of several methods. Moreover, primary tumor should be considered when rib fracture without trauma and tumor metastasis.

Radioisotope-guided localization and resection of non-palpable focal lesion of the rib.

Excisional biopsy of non-palpable rib tumors still represents a challenge for thoracic surgeons: in fact primary or metastatic tumors originating from a rib can be difficult to localize topographically at the time of excisional biopsy, thus potentially resulting in inappropriately placed skin incisions, incomplete tumor excision or even in wrong rib or segment resection (1).

Subxiphoid uniportal video‐assisted thoracoscopic surgery: A cosmetically superior approach to submammary rib tumor resection

This report describes a cosmetically superior approach to submammary rib tumor resection. Surgical resection is the most effective method for the treatment of rib tumors. Common surgical methods include thoracotomy and thoracoscopic surgery. Subxiphoid uniportal video‐assisted thoracoscopic surgery (VATS) has recently been described and is being increasingly used in a variety of thoracic procedures, including thymectomy, lobectomy, and resection of giant pleural fibroids. However, there has been no report in the literature which has described the use of uniportal subxiphoid VATS for rib tumor resection. We herein report the successful removal of fibrous dysplasia of the anterolateral segment of the sixth rib by subxiphoid uniportal VATS.

Effects of ultrasound-guided erector spinae plane block for pain relief in patients after rib tumor resection

Objective To explore the effects of ultrasound-guided erector spinae plane block(ESPB) for pain relief in patient after rib tumor resection. Methods A total of 40 patients (American Society of AnesthesiologistsⅠ-Ⅱ) undergoing rib tumor resection were randomly divided into two groups. Patients in group G received general anesthesia alone. Meanwhile, those in group E underwent ultrasound-guided ESPB combined under general anesthesia, and 20 ml of 0.5% ropivacaine was administered at the ESPB where rib tumor was located. Both groups received patient controlled intravenous analgesia (PCIA). The segments of sensory block on mid-axillary line were recorded 20 min after ESPB. The doses of remifentanil, mean arterial pressure (MAP), heart rate were recorded before entry into the operation room, after anesthesia induction, when the skin was excised, 30 min after surgery began and at the end of surgery. The rest and active visual analogue scale (VAS) at 1, 4, 12, 24 h and 36 h after operation, average hospitalization stay and patient satisfaction were recorded. Results Patients in group E reported 5.2±0.9 sensory block 20 min after ESPB. Compared with group G, group E used a less dose of remifentanil during operation, and demonstrated decreased MAP and heart rate when the skin was excised and at the end of surgery (P<0.05). Compared with group G, group E presented lower the rest and active VAS at 1, 4, 12, 24 h and 36h after operation and average hospitalization stay (P<0.05). Compared with group G, group E presented better patient satisfaction (P<0.05). Conclusions ESPB is safe and effective for patient after excision of rib tumor, with good patient satisfaction. Key words: Erector spinae plane block; Ultrasonic monitoring; Ribs; Bone neoplasms; Postoperative analgesia

Three-Dimensional Printing PEEK Implant: A Novel Choice for the Reconstruction of Chest Wall Defect

The purpose of this study is to use 3-dimensional printing (3DP) polyetheretherketone (PEEK) implants for skeletal reconstructions after wide excision of chest wall. 3DP PEEK implants were expected to provide a better physiological simulation than traditional ones because of a closer elastic modulus to cortical bone and similar biomechanical properties. Eighteen patients (mean age 44.5 years), comprising 6 males and 12 females, underwent adequate radical wide excision for tumors and chest wall reconstruction using 3DP PEEK implants. Surgical data, which include patient demographic characteristics, implant preparation parameters, and preoperative and postoperative pulmonary function test results, were collected and analyzed. Ten patients with rib tumors and 8 patients with sternum tumors were selected for the study. The mean chest wall defect size was 173.6 ± 151.5 cm2 (range, 55 to 625 cm2). The mean weight of a single 3DP PEEK riband sternum was 28 g and 104 g, respectively. The flexural and tensile strength of PEEK implants were 141 ± 7 MPa and 89 ± 3 MPa, respectively. Preoperative and postoperative pulmonary function tests revealed that mean forced vital capacity was from 2.79 ± 0.68 L to 2.40 ± 0.70 L with a reduction of 14.0% (p < 0.001). No side effects were observed 6 to 12 months after the operation. These findings suggest that 3DP PEEK implant is a safe and effective alternative in the reconstruction of chest wall defects. The pulmonary function of the patient may be preserved effectively after surgery.

The Rubbish Rib Tickler - Successful Complete Surgical Removal of Large Symptomatic Rib Tumour

The Rubbish Rib Tickler - Successful Complete Surgical Removal of Large Symptomatic Rib Tumour