Original article
Pediatric rib lesions: a 13-year experience

https://doi.org/10.1016/j.jpedsurg.2008.02.061Get rights and content

Abstract

Background

Rib lesions in the pediatric population are rare but significant processes and are often neoplastic.

Methods

All patients with primary rib lesions evaluated by the Department of Surgery at Children's Hospital Boston from 1992 to 2005 were studied. The patient's diagnosis, sex, symptoms and their duration, radiologic evaluation, biopsy status, surgical procedure, and follow-up were assessed.

Results

Thirty-three patients, ages 3 to 23 years (median, 12.7 years), were evaluated. Sixteen patients (48%) had benign and 17 (52%) had malignant lesions. Within the benign cohort of 16 patients, there were 6 osteochondromas, 4 aneurysmal bone cysts, and 2 fibrous dysplasias as well as 1 of each of the following: enchondroma, periosteal chondroma, eosinophilic granuloma, and chondrophyte. Within the malignant cohort of 17 patients, 13 were diagnosed with Ewing's sarcoma, 3 with osteogenic sarcoma, and 1 with chondrosarcoma. The sex distribution for the malignant group was 11 (65%) females and 6 (35%) males.

Conclusions

Rib tumors are rare entities in the pediatric population. However, a significant number of rib lesions are malignant. Therefore, proper diagnosis and expeditious treatment are critical.

Section snippets

Materials and methods

A retrospective chart review of all patients with primary rib lesions evaluated in the Department of Surgery at Children's Hospital Boston from 1992 to 2005 was performed. Thirty-three patients, ages 3 to 23 years (median, 12.7 years), were evaluated. Patient's diagnosis, sex, symptoms and their duration, radiologic workup, biopsy status, surgical procedure, and follow-up were documented. Patients with tumors arising from the lung, soft tissue, sternum, or scapula, and those patients with

Results

A total of 33 patients met the inclusion criteria. Sixteen patients (48%) had benign and 17 (52%) had malignant lesions. There were 17 females (52%) and 16 males (48%) included in the study, with males comprising a slightly higher percentage (62%) of the benign lesion cohort and females comprising a slightly higher percentage (65%) of the malignant lesion cohort.

The presenting symptoms reported were similar between the malignant and benign groups. Specifically, of the 16 benign rib lesions

Discussion

Rib tumors are rare entities in the pediatric population. However, a significant number of rib lesions are malignant. Our study, representing the experience of a major tertiary pediatric hospital, demonstrated a 52% incidence of malignant vs benign lesions. Selection bias likely influences the observed patient population, with a trend toward more complex (ie, malignant) lesions; conversely, a more general pediatric or surgical practice might observe a trend toward simpler (ie, benign) lesions.

References (15)

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These authors contributed equally to the study.

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