Bone Neoplasms ; Chondroblastoma ; Humans ; Ribs ; pathology

Aged ; Cell Dedifferentiation ; Chondrosarcoma ; pathology ; Humans ; Ribs ; pathology

We experienced a rare case of thoracic outlet syndrome caused by hypertrophic nonunion of the first rib. A diagnosis was made mainly upon provocative tests and imaging studies. Pain and tingling could be reproduced and the radial pulse obliterated by the hyperabduction test. Abundant callus formation on the posterior aspect of the first rib with fracture line was visible on plain radiograph. Two-dimensional computed tomography showed right thoracic outlet narrowing mainly caused by the mass-effect of the callus. Dynamic arteriographic studies revealed an external compression of the right subclavian artery and duplex ultrasonography demonstrated a reduction in right subclavian artery blood flow when the shoulder is in 90 degrees of abduction. Surgery was performed after the conservative management for three months which failed to relieve the patient of his complaints. Resection of the first rib via transaxillary approach was undergone uneventfully in combination with the myotomy of the scalenus anticus muscle. At postoperative one year follow up, the patient was free of symptoms, and had a full range of motion of the right shoulder with no evidence of arterial insufficiency.
Adult ; Case Report ; Human ; Hypertrophy ; Male ; Ribs/*pathology ; Thoracic Outlet Syndrome/*etiology/surgery

Primary hemangiopericytoma of the rib is extremely rare and only a few cases have been reported. A 62-yr-old man presented with an aching chest pain and dyspnea. Thoracic computed tomography revealed a homogenous mass expanding the right seventh rib. A diagnosis of hemangiopericytoma was established by percutaneous needle biopsy. Preoperative embolization of the feeding vessels of the tumor was performed in order to prevent perioperative bleeding. There was no significant bleeding during the surgery, where complete resection of the tumor with 7th to 9th ribs with a surgical margin of 5 cm was performed. Postoperative course was uneventful and there has been no recurrence for thirteen months. To our knowledge, there has been no report to apply a preoperative embolization of a primary hemangiopericytoma of the rib.
Bone Neoplasms/pathology/radiography/*surgery ; *Embolization, Therapeutic ; Hemangiopericytoma/pathology/radiography/*surgery ; Humans ; Male ; Middle Aged ; *Ribs ; Tomography, X-Ray Computed

Primary malignant fibrous histiocytoma (MFH) of the chest wall is rare. We report a case of primary MFH arising from the chest wall, which was thought to be a metastasis or myeloma. The imaging study revealed a single mass of the chest wall involving a rib. Resection and chest wall reconstruction was done. The histologic diagnosis was storiform-pleomorphic primary MFH. Although MFH of the chest wall is an uncommon pathology, it should be considered in the differentiation of a single bony destructive lesion involving the rib with a soft tissue component.
Adult ; Bone Neoplasms/*pathology/radiography ; Diagnosis, Differential ; Female ; Histiocytoma, Fibrous/*pathology/radiography ; Humans ; Ribs/*pathology ; Soft Tissue Neoplasms/*pathology/radiography ; Thoracic Wall/*pathology

Jarcho-Levin syndrome (JLS) is a condition manifested by malformations of vertebral bodes and related ribs. There are two major subtypes spondylocostal dysostosis and spondylothoracic dysostosis, with different survival rates, associated malformations, and inheritance patterns. We have experienced an autopsy case of a premature female fetus with multiple congenital anomalies. She was 30 weeks of gestational age, born as the second baby of twins and expired shortly after birth. A post-mortem examination revealed multiple abnormalities including cervicothoracic hemivertebrae, a diminished number of right-sided ribs, and pulmonary hypoplasia with left diaphragmatic hernia. In addition, there were anomalous rotation of the foregut, unfused pancreas and anomalous drainage of the superior vena cava. Chromosomal analysis showed 46, XX, del(4)(q ter).
Abnormalities, Multiple/genetics/*pathology ; Autopsy ; Chromosome Deletion ; Chromosomes, Human, Pair 4 ; Female ; Humans ; Infant, Newborn ; Ribs/*abnormalities ; Spine/*abnormalities ; Syndrome

OBJECTIVETo investigate the incidences and characteristics of the ribs and intraspinal abnormalities in surgical patients with congenital scoliosis.

METHODSWe conducted a retrospective study of the medical records and spine radiographs of 118 patients underwent surgical treatment between January 2010 and March 2011 with congenital scoliosis. The average age was 14 years (3-50 years).Fifty-two were male and 66 were female patients. The rib and intraspinal abnormalities were compared in different vertebral anomalies. Pearson's χ(2) test were used to analyze the incidence of anomalies of the ribs and vertebrae, as well as intraspinal anomalies.

RESULTSA total of 57 (48.3%) patients were found to have intraspinal abnormalities.Split cord deformities were identified to be the most common intraspinal anomaly (32.2%), followed by syringomyelia (21.2%).Sixty-nine patients (58.5%) had rib anomalies, which occurring on the concavity of the scoliosis was most frequent. The patients with mixed deformity and failure of segment were found to have a higher incidence of rib anomaly than those with failure formation (χ(2) = 14.05, P < 0.01). The patients with multiple level malformations were found to have significantly higher incidence of rib anomaly than those with single level malformation (χ(2) = 27.50, P < 0.01).Intraspinal anomalies occurred in 42 of 69 patients (60.9%) with rib anomalies and 15 of 49 patients (30.6%) without rib anomalies in congenital scoliosis. The occurrence of intraspinal malformation has significant difference with or without rib anomalies in congenital scoliosis (χ(2) = 10.5, P < 0.01).

CONCLUSIONSThe intraspinal malformation is common in patients with mixed defects and failures of segmentation. The rib anomalies occurring on the concavity of the scoliosis is most frequent. The incidence of intraspinal anomaly is significant higher in the patients with rib anomalies than those without rib anomalies. Both the occurrence and type of rib anomaly, combined with vertebral deformity are helpful in forecasting the occurrence of intraspinal abnormalis.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Incidence ; Kyphosis ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Ribs ; abnormalities ; Scoliosis ; classification ; congenital ; pathology ; Spine ; abnormalities ; Syringomyelia ; pathology ; Young Adult

Rib tuberculosis is an extremely rare condition with the incidence not exceeding 3 percent of all skeletal tuberculosis. The authors experienced a recalcitrant case of pulmonary tuberculosis accompanied by chest wall cold abscesses involving ribs recurring at a new site in approximately 10 months despite of medical and surgical treatment. The patient has twice taken thoracotomy for abscess drainage and during the second thoracotomy, a partial resection of involved ribs was performed
Adolescent ; Case Report ; Human ; Male ; Radiography, Thoracic ; Recurrence ; Ribs/pathology/*radiography/radionuclide imaging ; Thoracotomy ; Tomography, X-Ray Computed ; Tuberculosis, Osteoarticular/pathology/*radiography/radionuclide imaging

A case of a stillbirth with lethal type II osteogenesis imperfecta (OI) was reported. The fetus had skull fractures and craniocerebral injuries during pregnancy. Postmortem multi-sliced computed tomography (MSCT) and 3D-reconstruction were performed, followed by a medico-legal autopsy. The autopsic findings showed the typical features of type II OI, including a soft calvarium, deformed extremities, flexed and abducted hips, and uncommon features, such as white sclera, coxa vara, absence of several bones and organs, a cleft lip, and asymmetric ears. The radiologic images revealed such anomalies and variations as a cleft palate, mandibular dysplasia, spina bifida, costa cervicalis, and fusion of the ribs and vertebrae, which were difficult to detect during conventional autopsy. The paper investigated the classification, causative mutation, cause of death, and the differentiation of OI from child abuse, coming to a conclusion that OI knowledge can be of great importance to forensic pathologists and that the merits of postmortem MSCT should be emphasized in forensic pathologic examinations.
Autopsy ; Child ; Death ; Fatal Outcome ; Female ; Fetus ; Forensic Pathology ; Humans ; Infant, Newborn ; Multidetector Computed Tomography/methods* ; Osteogenesis Imperfecta/physiopathology* ; Pregnancy ; Ribs ; Skull/pathology*

We report a case of giant cell tumor originating from the anterior arc of the rib. The tumor and the surrounding chest wall were completely resected, and the chest wall defect was covered with Marlex mesh. Giant cell tumor of the bone usually originates from the epiphysis of long bones. Even when the tumor occur in ribs, it usually occur in the posterior aspect. However, giant cell tumor should be included in the differential diagnosis of a tumor originating from the anterior arc of the ribs.
Adult ; Bone Neoplasms/pathology/*radiography ; Diagnosis, Differential ; Giant Cell Tumor of Bone/pathology/*radiography ; Giant Cell Tumors/pathology/*radiography ; Humans ; Male ; Polypropylenes ; Ribs/pathology/*radiography ; Surgical Mesh ; Thoracic Wall/pathology/*radiography ; Tomography, X-Ray Computed