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Eur J Cardiothorac Surg 1999;15:615-620
© 1999 Elsevier Science NL

Tumours of the ribs: experience with 47 cases

^a Department of Thoracic Surgery, 401 Army General Hospital, Athens, Greece
^b Histopathology Laboratory, 401 Army General Hospital, Athens, Greece
^c Department of Computed Tomography, 401 Army General Hospital, Athens, Greece

Received 26 June 1998; received in revised form 20 January 1999; accepted 16 February 1999.

Corresponding author. 92 Pindou Road, Papagou 156 69 Athens, Greece Tel.: +301-651-8215; fax:+301-653-6952
e-mail: ega{at}otenet.gr

Objectives: To emphasise the existing difficulties in differentiating benign from malignant rib tumours, and especially the problems that a clinical doctor encounters when dealing with a hyperplastic rib. Methods: Forty-seven patients with rib tumour underwent surgery in a period of 12 years (1984–1996). In 40 cases (85%), the lesion was benign and in seven (15%) was malignant. Twenty-one benign tumours originated from cartilage and bone, seven were inflammatory, six originated from the bone marrow, and minor percentages (2.5–5%) had vascular, neurogenous, degenerative or miscellaneous origin. Three of the malignant tumours were primary chondrosarcomas and two were metastatic from kidney. The rest were metastatic from stomach (adeno-Ca), and skin (melanoma). The mean age in the benign group was 25.2 years and in the primary malignant group was 20.7 years. Related symptoms were pain (47%) and swelling (42.5%). One-third (32%) of the patients were asymptomatic and the lesion was accidentally found during routine chest radiography. All patients were treated surgically with wide excision of the tumour and the diagnosis was established histologically. Results: Resection was complete and curative in all cases without recurrence. Conclusions: Since the likelihood of malignancy cannot be excluded, all rib tumours should be considered malignant until proven otherwise. Therefore, prompt intervention is necessary and wide and radical initial excision of the involved rib is advocated.

Key Words: Thorax • Chest wall • Malignant • Benign • Rib hyperplasia • Costal cartilage