Primary osseous malignant fibrous histiocytoma involving a rib

✍ Scribed by J. Thomas Laverdiere; Tod G. Abrahams; Michael A. Jones

• Publisher: Springer
• Year: 1995
• Tongue: English
• Weight: 846 KB
• Volume: 24
• Category: Article
• ISSN: 0364-2348
• DOI: 10.1007/bf00198082

✦ Synopsis

Clinical information

A previously healthy, 86-year-old man developed progressive and debilitating chest discomfort over a 16month period. Initially, he noted the subtle onset of right anterolateral chest pain which was sharp in character and worse with activity. It did not increase with respiration nor was it associated with chest wall tenderness.

The patient was a 10pack/year smoker who quit in 1958. He had no prior history of asbestos exposure. He had no known underlying systemic illness and review of systems was unremarkable. Laboratory studies including serum alkaline phosphatase concentration were normal.

Physical examination at the time of admission revealed a nontender fullness in the right anterolateral chest wall just above the nipple. There was no erythema, discoloration, or discharge. The patient was afebrile.

Radiologic studies included a posteroanterior and lateral chest radiograph (Fig. 1). This revealed a largc, somewhat lobulated soft tissue mass along the lateral chest wall associated with lytic destruction of the anterior and lateral aspects of the fourth rib. There was no adenopathy or pulmonary nodules. Computerized tomographic (CT) imaging demonstrated