Thoracoscopy-assisted first rib resection for the treatment of thoracic outlet syndrome caused by fibrous dysplasia: A report of two cases

Rehemutula,Aierken; Zhang,Li; Yu,Cong; Chen,Lin; Gu,Yudong

doi:10.3892/etm.2015.2371

Thoracoscopy-assisted first rib resection for the treatment of thoracic outlet syndrome caused by fibrous dysplasia: A report of two cases

Authors:
- Aierken Rehemutula
- Li Zhang
- Cong Yu
- Lin Chen
- Yudong Gu
View Affiliations

Affiliations: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
Published online on: March 19, 2015 https://doi.org/10.3892/etm.2015.2371
Pages: 2241-2244

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

This study reports two rare cases of thoracic outlet syndrome (TOS) caused by fibrous dysplasia of the first rib. Two patients, aged 19 and 29 years old, were admitted with TOS in the lower trunk of the brachial plexus caused by an inflated first rib. In these two cases symptoms included hypoesthesia of the anterior medial aspect of the forearm and two fingers in the ulnar side, and progressive weakness of the upper limbs. Surgery was required to resect the first rib. Transaxillary and supraclavicular excisions were challenging to perform due to the involvement of the subclavian vasculature and brachial plexus. Thoracoscopy was used in these cases in order to peel the pleura off the first rib and facilitate resection by the supraclavicular approach. None of the patients exhibited nerve or vascular complications following the surgery.

View Figures

View References

1	Pang D and Wessel HB: Thoracic outlet syndrome. Neurosurgery. 22:105–121. 1988. View Article : Google Scholar : PubMed/NCBI
2	Roos DB: The thoracic outlet syndrome is underrated. Arch Neurol. 47:327–328. 1990. View Article : Google Scholar : PubMed/NCBI
3	Stanton PE Jr, Vo NM, Haley T, et al: Thoracic outlet syndrome: a comprehensive evaluation. Am Surg. 54:129–133. 1988.PubMed/NCBI
4	Fitzpatrick KA, Taljanovic MS, Speer DP, et al: Imaging findings of fibrous dysplasia with histopathologic and intraoperative correlation. Am J Roentgenol. 182:1389–1398. 2004. View Article : Google Scholar
5	Resnick D, Kyriakos M and Greenway GD: Tumors and tumor-like lesions of bone: imaging and pathology of specific lesionsDiagnosis of Bone and Joint Disorders. Resnick D: 4. 4th. WB Saunders; Philadelphia, PA: pp. 3833–3848. 2002
6	Kricun ME: Tumors of the ribsImaging of Bone Tumors. 1st. WB Saunders; Philadelphia, PA: pp. 304–328. 1993
7	Harris WH, Dudley HR Jr and Barry RJ: The natural history of fibrous dysplasia. An orthopaedic, pathological and roentenographic study. J Bone Joint Surg Am. 44-A:207–233. 1962.PubMed/NCBI
8	Jeung MY, Gangi A, Gasser B, et al: Imaging of chest wall disorders. RadioGraphics. 19:617–637. 1999. View Article : Google Scholar : PubMed/NCBI
9	Melliere D, Ben Yahia NE, Etienne G, et al: Thoracic outlet syndrome caused by tumor of the first rib. J Vasc Surg. 14:235–240. 1991. View Article : Google Scholar : PubMed/NCBI
10	Coote H: Exostosis of the left transverse process of the seventh cervical vertebra, surrounded by blood vessels and nerves, successful removal. Lancet. 1:360–361. 1861. View Article : Google Scholar
11	Roos DB: Transaxillary approach for first rib resection to relieve thoracic outlet syndrome. Ann Surg. 163:354–358. 1966. View Article : Google Scholar : PubMed/NCBI
12	Roos DB: Experience with first rib resection for thoracic outlet syndrome. Ann Surg. 173:429–442. 1971. View Article : Google Scholar : PubMed/NCBI
13	Devin R, Branchereau A, Pelissier JF, et al: Thoracic outlet compression syndrome by tumour of the first rib (authors transl). Chirurgie. 107:749–754. 1981.[(In French)]. PubMed/NCBI
14	Karanjia ND and Sayer RE: Thoracic outlet syndrome due to monostotic fibrous dysplasia of the first rib. J R Coll Surg Edinb. 35:1111990.PubMed/NCBI
15	Thomas de Montpréville V, Dulmet E, Ponlot R and Dartevelle P: Giant bilateral fibrous dysplasia of first ribs: compression of mediastinum and thoracic outlet. Eur Respir J. 8:1028–1029. 1995.PubMed/NCBI
16	Kemp CD, Rushing GD, Rodic N, et al: Thoracic outlet syndrome caused by fibrous dysplasia of the first rib. Ann Thorac Surg. 93:994–996. 2012. View Article : Google Scholar : PubMed/NCBI