title: Osteochondroma of the fifth rib resulting in recurrent hemothorax.
abstract: A 48-year-old man presented with recurrent spontaneous hemothoraces, which ultimately were found to be secondary to a pedunculated costal osteochondroma causing vascular injury. After initially undergoing endovascular coil embolization, he ultimately required segmental rib resection containing the offending lesion for definite treatment. Although a few cases of symptomatic costal osteochondromas have been reported in the literature, as far as we know, no previous reports have provided direct radiologic confirmation of active bleeding or the role of angiographic intervention. In this report, we highlight the importance of CT angiography in establishing a direct link between an osteochondroma and recurrent hemothorax. We also discuss the diagnostic imaging challenges associated with this condition and the use of a multidisciplinary treatment strategy involving both angiographic and operative management.
authors.affiliation: Department of Radiology - Musculoskeletal Imaging Fellowship, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44106, USA. mkpatel2@gmail.com.
authors.forename: Mital
authors.initials: M
authors.lastname: Patel
authors.affiliation: Departments of Pathology and Orthopaedic Surgery, The Cleveland Clinic L-25, 9500 Euclid Ave, Cleveland, OH, 44106, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Bauer
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Hillcrest Medical Building, 6801 Mayfield Road, Mayfield Heights, OH, 44124, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Santoscoy
authors.affiliation: Department of Radiology, Musculoskeletal Section, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44106, USA.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ilaslan
mesh_terms: D000792:Angiography / Q000379:methods; D001859:Bone Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006491:Hemothorax / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D015831:Osteochondroma / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D012008:Recurrence; D012272:Ribs / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Coil embolization; Costal; Hemothorax; Osteochondroma; Rib