title: Resection of the entire first rib for fibrous dysplasia using a combined posterior-transmanubrial approach.
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.
authors.affiliation: Department of General Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8559, Japan. masashifurukawa2000@hotmail.com
authors.forename: Masashi
authors.initials: M
authors.lastname: Furukawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Soh
authors.forename: Shinichi
authors.initials: S
authors.lastname: Toyooka
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
mesh_terms: D000328:Adult; D001706:Biopsy; D002637:Chest Pain / Q000209:etiology; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D056888:Patient Positioning; D012272:Ribs / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome