title: Chest wall osteochondroma in children: a case series of surgical management.
abstract: BACKGROUND
  Chest wall osteochondroma is a rare tumor in children. Even though the potential for malignant transformation or serious intrathoracic complications is low, it has led some centers to advocate surgical management of these bony tumors. We present our experience of the surgical management of costal osteochondromata.
  
  
  METHODS
  Between January 1, 2006 and November 1, 2012 we saw 854 patients with solitary or multiple exostoses in our clinics. By reviewing our billing lists we found 7 children who had surgical management of chest wall osteochondromata. The indications for surgery were pain (3 patients), excision for confirmation of diagnosis (2 patients), recurrent pneumothorax (1 patient), and malignancy (1 patient).
  
  
  RESULTS
  All patients made a good postoperative recovery with a median hospital stay of 1.8 days (range, 0 to 4 d). There was no recurrence of exostosis on follow-up (range, 8 mo to 2.6 y). One patient required surgery for excision of another chest wall osteochondroma at an adjacent location. No patient reported scar-related pain symptoms. No malignant transformation or intrathoracic complications occurred. We found ribs as the first site of presentation of multiple hereditary exostoses in 2 young patients.
  
  
  CONCLUSIONS
  Surgical management of thoracic osteochondroma, with excision for painful, symptomatic, malignant lesions or lesions adjudged to be at risk of intrathoracic complications, yields good outcomes in terms of symptom control, establishing histologic diagnosis, and prevention of thoracic complications.
  
  
  METHODS
  Level IV-case series.
authors.affiliation: Divisions of *Orthopaedic Surgery †Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Hooman
authors.initials: H
authors.lastname: Bakhshi
authors.forename: Indranil
authors.initials: I
authors.lastname: Kushare
authors.forename: Michael O
authors.initials: MO
authors.lastname: Murphy
authors.forename: James W
authors.initials: JW
authors.lastname: Gaynor
authors.forename: John P
authors.initials: JP
authors.lastname: Dormans
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D015831:Osteochondroma / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D012272:Ribs; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome