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Resection of the entire first rib for fibrous dysplasia using a combined posterior-transmanubrial approach

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Abstract

A 27-year-old woman presented with pain of the left anterior chest of 2-year duration. Chest X-ray revealed a mass in the upper-left lung field and chest computed tomography (CT) a 6-cm first-rib tumor. CT-guided biopsy was performed and the tumor diagnosed as fibrous dysplasia. Because of continued pain, surgery was deemed necessary. Surgery began with the use of the posterior approach in the prone position to expose the first thoracic vertebra and detach the first rib at the costotransverse joint. After transitioning to the spine position, the transmanubrial approach was used to resect the tumor en bloc with the left first rib. Histological examination revealed the tumor to be fibrous dysplasia. Postoperative recovery was uneventful. The outcomes of this case suggest that the combined posterior-transmanubrial approach described here is a safe, successful approach for first-rib resection of a space-occupying tumor that yields good cosmetic results.

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References

  1. Kransdorf MJ, Moser RP Jr, Gilkey FW. Fibrous dysplasia. Radiographics. 1990;10:519–37.

    PubMed  CAS  Google Scholar 

  2. Payne-James JJ, Walesby RK. Symptomatic fibrous dysplasia of the right first rib excised via a posterolateral thoracotomy. Thorax. 1986;41:575–6.

    Article  PubMed  CAS  Google Scholar 

  3. Hankin FM, Braunstein EM, Orringer MB. Timely evaluation of shoulder pain in a teenager. Am Fam Physician. 1986;33:177–80.

    PubMed  CAS  Google Scholar 

  4. Karanjia ND, Sayer RE. Thoracic outlet syndrome due to monostotic fibrous dysplasia of the first rib. J R Coll Surg Edinb. 1990;35:111.

    PubMed  CAS  Google Scholar 

  5. Melliere D, Ben Yahia NE, Etienne G, Becquemin JP, de Labareyre H. Thoracic outlet syndrome caused by tumor of the first rib. J Vasc Surg. 1991;14:235–40.

    Article  PubMed  CAS  Google Scholar 

  6. de Montpreville TV, Dulmet E, Ponlot R, Dartevelle P. Giant bilateral fibrous dysplasia of first ribs: compression of mediastinum and thoracic outlet. Eur Respir J. 1995;8:1028–9.

    Google Scholar 

  7. Hiremagalur SR, Whitaker JH, Kumari NA, Roy TM. Fibrous dysplasia of the rib: an unusual cause of chest pain. Tenn Med. 1997;90:406–7.

    PubMed  CAS  Google Scholar 

  8. Silins I, Simanovica I, Rone I. Resection of the first rib for fibrous dysplasia by transmanubrial approach. Acta Chir Latv. 2010;10:115–7.

    Article  Google Scholar 

  9. Roos DB. Transaxillary approach for first rib resection to relieve thoracic outlet syndrome. Ann Surg. 1966;163:354–8.

    Article  PubMed  CAS  Google Scholar 

  10. Grunenwald DH, Mazel C, Girard P, Veronesi G, Spaggiari L, Gossot D, et al. Radical en bloc resection for lung cancer invading the spine. J Thorac Cardiovasc Surg. 2002;123:271–9.

    Article  PubMed  Google Scholar 

  11. Dartevelle PG, Chapelier AR, Macchiarini P, Lenot B, Cerrina J, Ladurie FL, et al. Anterior transcervical–thoracic approach for radical resection of lung tumors invading the thoracic inlet. J Thorac Cardiovasc Surg. 1993;105:1025–34.

    PubMed  CAS  Google Scholar 

  12. Grunenwald D, Spaggiari L. Transmanubrial osteomuscular sparing approach for apical chest tumors. Ann Thorac Surg. 1997;63:563–6.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Masashi Furukawa.

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Furukawa, M., Soh, J., Toyooka, S. et al. Resection of the entire first rib for fibrous dysplasia using a combined posterior-transmanubrial approach. Gen Thorac Cardiovasc Surg 60, 584–586 (2012). https://doi.org/10.1007/s11748-012-0044-0

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  • DOI: https://doi.org/10.1007/s11748-012-0044-0

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