Study design: A case report is presented.
Objectives: Primary tumors of the rib are relatively uncommon in the adult population, and even more rare in children. A case of osteogenic sarcoma of the rib and a literature review are presented.
Summary of background data: Osteogenic sarcoma represents approximately 30% of all malignant sarcomas diagnosed in the United States. A single case of osteogenic sarcoma of the rib has been reported in the literature involving a 9-year-old child.
Methods: Clinical data analysis.
Results: A 9-year-old white boy presented with a mass of the left posterior thorax. The initial chest radiograph showed a nonhomogeneous mass with calcifications adjacent to the 11th rib. The final diagnosis was osteogenic sarcoma. Chemotherapy was initiated. The patient underwent radical excision of the mass. Given the extent of the patient's resection, it was thought that he would be at high risk for the development of spinal deformity. He was placed in a TLSO brace (Bolt Systems, Orlando, FL) and followed closely. At 15 months after excision of his tumor, he was noted to have progression of a thoracolumbar scoliosis and significant kyphosis. At this writing, it has been 52 months since resection. The patient has no evidence of local recurrence or metastatic disease, and his spinal curvature remains stable.
Conclusions: The patient's short-term (4-year) disease-free survival illustrates the efficacy of neoadjuvant chemotherapy and radical surgical resection. Patients with osteogenic sarcoma of the rib should be monitored closely for the development of spinal deformity if the required resection includes the vertebral column. Casting and bracing may help to limit progression of the deformity.