A case of costal osteochondroma

Abstract

A 20-year old male was referred from another institution with a complaint of severe left-sided chest pain and an abnormal shadow on a chest roentgenogram. Chest computed tomography revealed a 2-cm, horn-like mass, which showed bone density, arising from the left fifth rib, and an abnormal soft tissue shadow at the pericardial pleura that expanded from the peak of the mass. Video-assisted thoracoscopic surgery revealed a bony, spiculated mass at the anterior portion of the fifth rib and thickening of the visceral and pericardial pleura opposite the mass. A mini-thoracotomy (2 cm) was performed through the fifth intercostal space just above the mass, which was subsequently resected using a Luer bone rongeur. A biopsy sample was obtained from the thickened pericardial pleura. Histopathological examination of the resected specimen confirmed osteochondroma. Pleural thickening was consistent with a reactive change that occurred in response to chronic stimulation by the mass. The left-sided chest pain disappeared shortly after surgery.