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Fibrous Dysplasia

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  • • Accounts for 33% of benign skeletal tumors

    • Involves ribs 50% of time

    • Not associated with hyperparathyroidism

    • Usually single tumor, associated with trauma

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Chondromas, Osteochondromas, Myxochomdromas

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  • • Combined equal 30-45% of benign skeletal tumors

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Eosinophilic Granuloma

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  • • Occurs in clavicle and scapula usually; rarely in sternum

    • Lung infiltrates are common

    • Benign form of Litterer-Siwe disease or Hand-Schuller-Christian disease

    • Cavernous hemangioma of ribs

    • -Painful mass during childhood

    • Multiple radiolucent areas or single trabeculated cyst seen on radiograph

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Epidemiology

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Chondroma

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  • • Occurs equally among males and females, between childhood and fourth decade

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Symptoms and Signs

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  • • Most often painless

    • Swelling and tenderness may occur with fibrous dysplasia

    • Chondromas occur along anterior costal margin

    • Lung infiltrates—consider eosinophilic granuloma

    • Fever, malaise, leukocytosis—consider eosinophilic granuloma

    • Bone pain—consider eosinophilic granuloma

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Imaging Findings

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  • • X-ray often diagnostic

    • Lung infiltrates—consider eosinophilic granuloma

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  • • Can be difficult to distinguish from malignant lesions

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  • • Physical exam to assess skin involvement

    • CT scan of thorax including bone windows

    • Bone scan

    • Incisional biopsy for large mass (> 4 cm)

    • Excisional biopsy if small and amenable

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  • • Wide local excision often necessary for cure

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References

Burt M et al. Primary bony and cartilaginous sarcomas of chest wall: results of therapy. Ann Thorac Surg. 1992;54:226.  [PubMed: 1637209]
Brodsky JT et al. Desmoid tumors of the chest wall: a locally recurrent problem. J Thorac Surg. 1992;104:900.  [PubMed: 1405687]

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