PMC4451703_01
On chest radiograph, masses (arrows) in the chest wall (more prominent on the right) causing extensive destruction, deformation and splaying of the ribs, and mild levoscoliosis (A). On contrast-enhanced thoracic CT, intrathoracic extension of masses originating from the right 3rd-4th ribs and the left 3rd-4th ribs, more prominent on the right (asterisk). Calcifications can be seen inside the hamartoma of the left thoracic wall (arrows) (B).
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Extensive bilateral rib destruction, splaying and deformation were observed in addition to levoscoliosis (Figure 1A). Contrast-enhanced thoracic CT performed for differential diagnosis revealed solid mass lesions measuring 3x3 cm in the right hemithorax at the 3rd-4th ribs and 2x2 cm at the 6th-7th ribs, and 5x3 cm in the left hemithorax at the 3rd-8th ribs, with intense calcifications and marked intrathoracic extension (Figure 1B).
On volume rendered images, intense calcifications at the right 3rd-4th ribs, 6th-7th ribs and the left 3rd-8th ribs (arrows) (A), posteriorly expanded and deformed left 3rd, 4th and 6th ribs (arrows) (B).
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Volume rendered images clearly demonstrated the destruction, expansion, and calcified components in the affected ribs as well as splaying of the bilateral 3rd-8th ribs (Figure 2A). The left 3rd, 4th and 6th ribs appeared posteriorly expanded and deformed (Figure 2B).
Histopathological findings of chest wall mass biopsy. Aneurysmal cystic walls and scattered osteoclast-like giant cells (A). Reactive bone and cartilage tissue (hematoxylin and eosin stain, original magnification x40) (B).
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Histopathological analysis showed aneurysmal cystic walls, scattered osteoclast-like giant cells and reactive bone and cartilage tissue, leading to a diagnosis of thoracic wall hamartoma (Figure 3A, 3B).