Painful Snapping Shoulder Complicating Soft Tissue Pseudotumor Secondary to Rib Osteochondroma: A Case Report

Myung-Sang Moon; Dal-Jae Jeon; Sung-Soo Kim; Min Geun Yoon

doi:10.5292/jkbjts.2014.20.1.27

Journal List > J Korean Bone Joint Tumor Soc > v.20(1) > 1052044

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Moon, Jeon, Kim, and Yoon: Painful Snapping Shoulder Complicating Soft Tissue Pseudotumor Secondary to Rib Osteochondroma: A Case Report

Case Report

J Korean Bone Joint Tumor Soc 2014;20(1):27-31.

Published online: 10 June 2014

DOI: https://doi.org/10.5292/jkbjts.2014.20.1.27

Painful Snapping Shoulder Complicating Soft Tissue Pseudotumor Secondary to Rib Osteochondroma: A Case Report

Myung-Sang Moon, Dal-Jae Jeon, Sung-Soo Kim, Min Geun Yoon

Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju, Korea

Correspondence to: Min Geun Yoon Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Dorhyungro 65, Jeju 690-766, Korea TEL: +82-64-740-5030 FAX: +82-64-743-3110(hospital), + 82-64-740-5410(orthopedics) E-mail: msmoon@hotmail.com, hallosjun@gmail.com

Received 3 March 2014 Revised 30 May 2014 Accepted 4 June 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Osteochondromadevelop most commonly at distal femur, proximal humerus and proximal tibia, but the rib osteochondroma was reported less commonly. In this report, scapular snapping syndrome complicated by adventitious bursa and soft tissue pseudotumor surrounding the osteochondroma of the 6^th rib body was treated successfully by surgical excision of them. We report this rare case with reviewing the relevant literature.

Keywords: rib, osteochondroma, scapular snapping, soft tissue pseudotumor, adventitious bursa

References

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Figure 1.

On preoperative x-ray about 1.2 cm size exophyticbony mass (white arrow) is noted on the middle part ofthe left 6^th rib (A). On MRI about 1.2×1 cm sized exophytic bony lesion (white arrow) in posterolateral arc of the left 6th rib with surrounding loculated fluid-signal like collection (white arrow head) is seen (B).

Figure 2.

Excised osteochondroma (white arrow) with surrounding soft tissue (dark arrow head) is shown. The surrounding soft tissue has soft and amorphous shape bursal sac and relatively hard pseudotumor, which cannot be demarcated well.

Figure 3.

Histologic section shows thickened bone and cartilage fragment. The mature bone stalk is covered with well differentiated cartilagenuous cap with irregular tidemark (H&E, ×40).

Table 1.

Review of the Cases Reported in the International Literature with Rib Osteochondroma

Case	Author	Age	Type	Location	Clinical problem
1	Pelc HJ, Pediatr Surg Int. 2014	2	Hereditary multiple	Rt. 8^th rib	Asymptomatic deformity
2	Simpson JF, J Clin Diagn Res. 2014			1^st rib	Horner's syndrome
3	Liu W, J Pediatr Orthop B 2013	42	Hereditary multiple	Lt. 4^th rib	Kyphosis, pain
4	Chen J, Skeletal Radiol. 2013	7	Solitary		Lung injury after trauma
5	Amritanand R, BMC Musculoskelet Disord. 2012		Hereditary multiple	Lt. 2^nd rib	Spinal cord compression, scoliosis
6	Shim JH, Bol Asoc Med P R. 2011	58	Solitary	12^th rib	Spinal cord compression
7	Marino-Nieto J, H Vasc Surg. 2011	7	Solitary	Lt. 4^th rib	Painless swelling
8	O’Brien PJ, Gen Thorac Cardiovasc Surg. 2010		Solitary	1^st rib	Thoracic outlet syndrome
9	Kikuchi R, J Pediatr Surg. 2010	73	Solitary	Rt. 4^th rib	Asymptomatic
10	Khosla A, Spine 2008	17	Solitary	Lt. 5^th rib	Pneumothorax
11	Mannoji C, Rev Mal Respir. 2008	10	Hereditary	Lt. 8^th rib	Paraparesis
12	Codron F, J Pediatr Surg. 2005	22	Hereditary	7^th rib	Hemothorax
13	Pham-Duc ML, J Pediatr Surg. 2005	15	Solitary		Hemothorax
14	Cowles RA, Pediatr Radiol. 2005	6	Hereditary	3 Lt. rib	Hemothorax, pericardial effusion
15	Jin W, Eur J Cardiothorax Surg. 2003	11	Solitary	Lt. 6^th rib	Hemothorax, Lacerated left hemidiaphragm
16	Alifano M, Ann Thorac Surg. 2003	15	Solitary	Lt. 4^th rib	Hiccup, chest pain
17	Hajjar WM, Eur J Cardiothorac Surg. 2001				Hemorrhagic shock Repetitive chest infection
18	Buchan KG, Acta Chir Orthop Traumatol Cech. 2000	21	Solitary	Lt. 4^th rib	Hemothorax
19	Steno B, Rev Chir Orthop Reparatrice Appar Mot. 1998	21	Solitary	1^st rib	Asymptomatic
20	Cottalorda J, Spine 1998	15	Hereditary		Chest pain
		11	Solitary		Asymptomatic
21	Tang WM, J Bone Joint Surg. 1997	15	Hereditary	Rt. 12^th rib	Spinal cord compression
22	Wright JM, Ann Thorac Surg. 1997	19	Hereditary	Lt. 2^nd rib	Haemothorax
23	Simansky DA, Ann Thorac Surg. 1996	17	Solitary		Haemothorax, Lacerated diaphragm
24	Gupta NK, Thorax. 1994			1^st rib	Exostosis bursa
25	Harrison NK, Surg. Neurol. 1994	36	Solitary	Lt. 4^th rib	Haemothorax
26	Kane PJ, Nihon Kyobu Geka Gakkai Zasshi. 1991				Spinal cord compression
27	Suzuki T, Rev Chir Orthop Reparatrice Appar Mot. 1990	21	Hereditary	Rt. 6^th, 7^th rib	Pneumothorax
28	Rosset P, Ann Thorac Surg. 1989		Solitary	1^st rib	Thoracic outlet syndrome
29	Teijeira FJ, Kyobu Geka. 1989	7	Hereditary	Lt. 6^th rib	Hemothorax
30	Koike R, Orthopedics. 1984	51		1^st rib	Asymptomatic
31	Cain PR, Can Med Assoc J. 1948			1^st rib	Pseudoarthrosis with clavicle

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