Fibrous Dysplasia of Ribs and Spine: Multidisciplinary Solution – a Case Report

Česká verzia

Authors: P. Habal ¹; K. Kaltofen ²; R. Kostyšyn ²; M. Štětina ¹; V. Málek ²
Authors place of work: LF UK a FaN Hradec Králové Kardiochirurgická klinika ¹; LF UK a FaN Hradec Králové Neurochirurgická klinika ²
Published in the journal: Cesk Slov Neurol N 2010; 73/106(6): 734-737
Category: Case Report

Summary

By relating the case history of a 56-year-old patient with multicentric fibrous dysplasia of the 5th and 6th ribs, the authors outline treatment procedures employed by both a thoracic surgeon and a neurosurgeon. A tumour was compressing the right lung and causing breathlessness by creating pleural effusions. One part of the tumour penetrated into the canal of the vertebral column and compressed the spinal cord. The patient had been examined in various departments; a surgical solution was suggested after spastic paraparesis of the lower limbs developed. The acute phase of spinal cord compression was relieved by laminectomy. In the second phase, the tumour was extirpated from the thoracic wall, with resection of the affected parts of the ribs and thoracic vertebrae. In the third phase, the spine was stabilized with plastic surgery to the thoracic wall. The tumour, measuring 60 × 110 × 80 mm, weighed 1,200 g. The large resection area gave rise to bleeding that was difficult to stop; local application of haemostat Traumacel TAF reduced the blood loss significantly. This result indicates that we may recommend surgical treatment in the case of enormous, benign tumours, with cooperation from exponents of other surgical specialities.

Key words:
thoracic wall tumours – benign fibrous dysplasia – lower paraparesis

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