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Weekly Chest CasesArchive of Old Cases

Case No : 1043 Date 2017-10-23

  • Courtesy of Yeseul Jo, Sarah Kyongmin Beck, Dae Hee han, Jung Im Jung, Myoeng Im Ahn / Seoul St. Mary hospital
  • Age/Sex 61 / F
  • Chief ComplaintChest wall mass
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Chondrosarcoma
Radiologic Findings
CT scan shows an about 7cm sized lobulated enhancing mass in left 9th rib near the costochondral junction, with bony destruction, containing internal stippled chondroid calcifications and necrotic portion. Invasion was suspicious, into L diaphragm and adjacent chest wall muscles.
Brief Review
Chondrosarcoma is the most common primary malignant rib neoplasm, usually arises at or near the costochondral junction. Incidence peak at the age of 50 years. it is rare in individuals younger than 20 years. Although some chondrosarcomas may not have radiographically visible calcifications, most lesions usually involve the anterior rib at the costochondral junction and show osseous expansile remodeling with a ring-and-arc pattern of calcification and soft-tissue extension on both radiographs and CT. The nonmineralized components, both intraosseous and extraosseous, typically have low attenuation on CT scans, reflecting the high water content of hyaline cartilage. CT performed after intravenous administration of contrast material demonstrates mild peripheral rim and septal enhancement. Higher-grade lesions may show higher CT attenuation, similar to that of muscle, and more prominent diffuse or nodular contrast enhancement, caused by increased cellularity and resultant reduced water content.
References
1. Benjamin D. Levine, Kambiz Motamedi, Kira Chow, Richard H. Gold, and Leanne L. Seeger. CT of Rib Lesions. American Journal of Roentgenology 2009 193:1, 5-13
2. Mark D. Murphey, Eric A. Walker, Anthony J. Wilson, Mark J. Kransdorf, H. Thomas Temple, and Francis H. Gannon. Imaging of Primary Chondrosarcoma: Radiologic-Pathologic Correlation. RadioGraphics 2003 23:5, 1245-1278
Please refer to
Case 563 Case 296 Case 141
Keywords
Chest wall, Rib, Neoplasm, Malignant neoplasm,

No. of Applicants : 84

▶ Correct Answer : 33/84,  39.3%
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - Higashi-Ohmi General Medical Center , Japan AKITOSHI INOUE
  • - University of Florence , Italy MARIAELENA OCCHIPINTI
  • - PRINCE SATTAM IBN ABDULAZIZ UNIVERSITY HOSPITAL , Saudi Arabia ELBAGIR MOHAMED NASSIR
  • - University of Tsukuba , Japan Toshitaka Ishiguro
  • - 罹…stanbul , Turkey AYHAN YILMAZ
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - 怨„紐… , Korea (South) jin young kim
  • - Scans world , India PHILSON JOSEPH MUKKADA
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Ajou University Hospital , Korea (South) SEULGI YOU
  • - The University of Tokyo Hospital , Japan Yusuke Watanabe
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - The first affiliated Hospital of Xiamen University , China Qing Qiang Guo
  • - King Abdulaziz University Hospital , Saudi Arabia Amr M. Ajlan
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Asan Medical Center , Korea (South) HYUN JUNG KOO
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - The Jikei university , Japan TAKU GOMI
  • - Chungbuk National University Hospital , Korea (South) HYEONMI RYU
  • - Chungbuk national university hospital , Korea (South) Miran Yeon Yeon
  • - Chung buk national university hospital , Korea (South) hong gwon Byun
  • - HHS , Canada S LEE
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - The University of Tokyo Hospital , Japan TAKU TAJIMA
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - Teikyo University Hospital , Japan KAORU SUMIDA
  • - Ajou University Hospital , Korea (South) Taeyang Ha
  • - Hyogo Prefectural Amagasaki General Medical Center , Japan TOMOAKI OTANI
▶ Correct Answer as Differential Diagnosis : 18/84,  21.4%
  • - Korea university medical center, guro hospital , Korea (South) Lee kyu chong
  • - The University of Tokyo Hospital , Japan Akifumi Hagiwara
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - University of Utah , United States AKIHIKO SAKATA
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - District TB centre, kasaragod,India , India rikhy krishnan
  • - Chonnam National University Hospital , Korea (South) GUNSU KIM
  • - Amagasaki General Medical Center , Japan GENKI FUKUMOTO
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Niigata University , Japan ATSUSHI UEHARA
  • - Azienda Ospedaliera di Cremona , Italy Pietro Sergio
  • - Mallinckrodt Institute of Radiology , United States Naganathan BS Mani
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
  • - Samsung Medical Center , Korea (South) KYOWON GU
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Hanyang University Hospital , Korea (South) KYGUNG RI PARK
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
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