Osteosarcoma of the rib

A case report of rib osteosarcoma and literature review

About half of osteosarcomas occur near the knee joint, but other sites such as the humerus, upper femur, fibula, spine, and ilium can also occur. However, rib osteosarcoma is rarely reported. Here, we report the case of a 17-year-old female who was found to have a left dorsal mass on physical examination. Computed tomography (CT) revealed bone destruction in the seventh rib, leading to surgery for mass excision. Pathological results suggested chondroblastic osteosarcoma. After surgery, the patient was treated with chemotherapy and is doing well.

Rosette-forming epithelioid osteosarcoma in the rib: a rare case of location and morphology

The rib is an unusual location for osteosarcoma and is reported in only 2% of all cases. The major histological variants of osteosarcoma are osteoblastic, chondroblastic, and fibroblastic, with a few rare variants including one epithelioid type. This report describes a 44-year-old male with an osteolytic mass in the right seventh rib. Histological examination revealed osteosarcoma with unique features of epithelioid appearance and rosette structures. To the best of our knowledge, this is the first reported case of a rosette-forming osteosarcoma of the rib that showed epithelioid morphology. Despite successful surgery, the patient’s prognosis was poor because this malignancy had an unusual location within the axial skeleton and was a rare histological variant.

Radical resection of a giant rib osteosarcoma with complex chest wall reconstruction

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A 61-year-old male with a 20 cm primary osteosarcoma of the rib underwent a radical en bloc chest wall resection.

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Chest wall reconstruction was performed using a poly methyl methacrylate (“bone cement”) and polypropylene mesh “sandwich”.

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Functional, cosmetic, and oncologic outcomes at 6 months are excellent.

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Polypropylene mesh and “bone cement” represent a safe, easy, and affordable approach to reconstructing the rib cage even in cases of large defects.

Introduction

Primary rib osteosarcoma is a rare chest wall tumor with variable presentation. Large tumors greater than 10 cm are even rarer and present a challenge for surgical management.

Presentation of case

A 61-year-old male with a giant osteosarcoma of the left 2^nd rib underwent multidisciplinary management including induction therapy with doxorubicin and cisplatin, followed by en bloc resection with left ribs 1–5, spinous processes of ribs 2–5, small volume lung resection, and chest wall reconstruction with polypropylene mesh and poly methyl methacrylate (PMMA or bone cement). There were no perioperative complications. At 6 months follow-up, the patient remains disease-free. Functional and cosmetic outcome are excellent.

Discussion

This 20 cm mass and resection of ribs 1–5 with resulting 25 cm chest wall defect is the largest primary rib osteosarcoma reported in literature. An R0 resection and chest wall reconstruction using polypropylene mesh and bone cement was feasible and safe.

Conclusion

Giant chest wall defects involving multi-rib resection can be effectively reconstructed with commonly available and inexpensive polypropylene mesh and PMMA to achieve good cosmetic and functional outcomes.

Primary Osteosarcoma of the Rib: A Case Report and Review of the Literature

Osteosarcoma is the most common primary malignant tumor of the bone. The most common sites of osteosarcoma in children are the metaphysis of long bones, especially the distal femur, proximal tibia, and proximal humerus. It occurs very rarely in flat bones. Here we report a 14-year-old adolescent boy with primary osteosarcoma of the fifth rib and a review of literature.

The Management Challenges in an Unusual Case of Primary Osteosarcoma of the Rib in an Adult Patient

Primary osteosarcomas are derived from primitive bone-forming mesenchymal stem cells and most often originate in the metaphysis of the long bones of children and adolescents, but it occurs very rare in adults. Approximately 10% of osteosarcomas are located in the flat bones, pelvis being the main site. Involvement of flat bones like rib may be seen as a metastatic process or secondary to chemotherapy, but a primary osteosarcoma rib is extremely rare. Osteosarcoma originating from such rare sites poses numerous diagnostic and therapeutic challenges, and we report one such case in a 24-year-old male patient. Our case highlights the fact that osteosarcoma of the rib, although rare, should be considered in the differential diagnosis of primary malignant neoplasms of the rib even in the adult population. Further, early prompt diagnosis and aggressive multimodality management are cornerstones of management and will help improve the survival outcomes.

Chest wall tumors: Diagnosis, treatment and reconstruction

The aim of the present study was to determine a suitable procedure for the treatment of chest wall neoplasms with less potential risk and an increased rate of survival. Fifty patients with suspected chest wall malignancies were analyzed using various preliminary investigation tools. Whole-chest scanning was performed in all the patients. The patients were subsequently subjected to biopsies for further confirmation of the neoplasm. All such patients were then treated with a surgical approach and radiation therapy, with a follow-up period lasting up to six years. The majority of the patients showed improved survival rates relative to conventional therapies. The survival rates of patients suffering from osteosarcoma (78%) were higher those of patients with rhabdomyosarcoma (73%) and malignant small round cell tumors (64%). The survival and the mortality rates of the patients with synovial sarcoma and fibrosarcoma were the same. This study, which was conducted on a small group of patients, has provided guidance for further studies on tumors of the chest wall, which may, in turn, increase the longevity of affected patients.

Unusual case of chondroblastic osteosarcoma of the rib in an adult

Primary osteosarcoma arising from the ribs is very rare. An unusual case of a primary chondroblastic osteosarcoma of the rib in a 30-year-old woman is described here. The patient underwent wide excision of the tumor along with the involved rib, followed by chemotherapy. Although clinically unsuspected in this unusual site, pathology confirmed a completely resected chondroblastic osteosarcoma.

An unusual case of primary osteosarcoma of the rib in an adult

Primary osteosarcomas are one of the most common malignant bone tumors principally affecting the long bones in children and adolescents. An unusual case of a primary osteoblastic osteosarcoma of the rib in a 42-year-old male is presented here. The patient underwent a wide excision of the tumor and chest wall reconstruction. Although clinically unsuspected in this unusual site, the classic microscopic feature of a ramifying osteoid matrix amidst the tumor cells was diagnostic of an osteosarcoma.

Osteosarcoma of the rib

This case describes the radiological-surgical correlation of a rare case of osteosarcoma of the rib in a 15-year-old boy. Successful repair of his chest wall defect using a wire mesh following extensive surgical resection of the tumour is highlighted, such a procedure being the first instituted at our centre.

Osteosarcoma of rib in a seven-year-old child: a case report

Primary tumours of ribs are relatively uncommon in adults and are even rarer in children. (William in Am Surg June: 338-342, 1972; Eskenasy in Rev Roum Morph Embryol Physio 1:35-50, 1985) Osteosarcoma is the most common primary bone malignancy in children and young adults. (Whelan in Eur J Can 33(10):1611-1619, 1997) Very few cases of osteosacoma of the rib have been described in literature. We report a 7-year-old girl with primary osteosarcoma of the rib which was managed by wide excision followed by adjuvant chemotherapy. She is disease free after 12 months of follow-up. We believe our case to be the youngest with primary osteosarcoma of the rib. Primary osteosarcoma of the rib should be considered in the differential diagnosis in a child with rib swelling. Early diagnosis and treatment improves the outcome.