Abstract：Objective: To analyze the imaging appearance and to explore the diagnostic value of CT in primary malignant tumors of the ribs. Methods: Twenty-six cases with primary malignant costal tumors proved by operation and pathology were analyzed, and radiographic features were analyzed retrospectively. Results: There were 14 cases of chondrosarcoma with 78.5% arising at the costochondral junction, characterized by irregular and lytic bone destruction with cartilage matrix calcification inside. After intravenous injection, no obvious enhancement was seen. There were 4 cases of plasmacytoma, characterized by solitary or multiple, punched-out or eroded lesions. Osteosarcoma(three cases) appeared as osteolytic or mixed bone destruction, irregular calcific densities were found in one case. Ewing’s sarcoma(two cases) demonstrated as ill-defined, osteolytic lesions with a large soft tissue mass in one case. The rest were one of each of the following: non-Hodgkin’s lymphoma, chordroma, fibrosarcoma, and liposarcoma. Conclusion: The primary malignant tumors of the ribs are a complicated group and rarely encountered, some of which demonstrate the classic radiological features, but some cases with nonspecific radiological features, and the final diagnosis should consider about clinical, imaging and pathology.
常 承，彭晓新，程晓光，于爱红，宫丽华. 肋骨原发恶性骨肿瘤的CT诊断[J]. 中国临床医学影像杂志, 2020, 31(6): 441-445.
CHANG Cheng, PENG Xiao-xin, CHENG Xiao-guang, YU Ai-hong, GONG Li-hua. CT findings of the primary malignant tumors of the ribs. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(6): 441-445.
[1]Andrianopoulos EG, Lautidis G, Kormas P, et al. Tumours of the ribs: experience with 47 cases[J]. Eur J Cardio-thorac Surg, 1999, 15(5): 615-620.
[2]郭道芳，邢溪萍，郭美红. 肋骨原发性肿瘤的影像学诊断（附18例分析）[J]. 医学影像学杂志，2000，10（2）： 95-96.
[3]范国华，钱铭辉，龚建平，等. 肋骨肿瘤的CT诊断[J]. 临床放射学杂志，2005，24（3）：246-248.
[4]母华国，桑玲，吴德红，等. 肋骨原发性软骨肉瘤的影像表现[J]. CT理论与应用研究，2015，24（4）：595-602.
[5]胡碧莹，徐维敏，文婵娟，等. 肋骨原发性骨肿瘤的影像表现（附14例报告）[J]. 医学影像学杂志，2013，23（11）：1766-1770.
[6]Kim S, Lee S, Arsenault DA, et al. Pediatric rib lesions: a 13-year experience[J]. J Pediatr Surg, 2008, 43(10): 1781-1785.
[7]Ohaba K, Chen F, Date H. Rib chondrosarcoma with intramedullary progression completely resected by magnetic resonance imaging: useful short inversion time inversion recovery sequence[J]. Interact Cardiovasc Thorac Surg, 2011, 12(5): 853-854.
[8]Nam SJ, Kim S, Lim BJ, et al. Imaging of primary chest wall tumors with radiologic-pathologic correlation[J]. Radiographics, 2011, 31(3): 749-770.
[9]Shapeero LG, Vanel D, Couaner D, et al. Extraskeletal mesenchymal chondrosarcoma[J]. Radiology, 1993, 186(3): 819-826.
[10]Athanassiadi K, Kalavrouziotis G, Rondogianni D, et al. Primary chest wall tumors: early and long-term results of surgical treatment[J]. Eur J Cardiothorac Surg, 2001, 19(5): 589-593.
[11]Yaman Bajina I, Kurucu N, Oquz B, et al. Primary osteosarcoma of the rib: a case report and review of the literature[J]. J Pediatr Hematol Oncol, 2018, 40(1): 48-50.
[12]杨旦君，王丰富，戚洪波，等. 肋骨骨肉瘤一例报告[J]. 现代实践医学，2010，22（10）：1190.
[13]Mohanty S, Inchara YK, Crasta JA, et al. An unusual case of primary osteosarcoma of the rib in an adult[J]. Indian J Med Paediatr Oncol, 2010, 31(1): 18-20.
[14]袁敏，江旭，杨继金，等. 成人骨肉瘤的影像诊断（附21例报告）[J]. 实用放射学杂志，2011，27（3）：421-424.
[15]Thomas PRM, Foulkes MA, Gilula LA. Primary Ewing’s sarcoma of the ribs: a report from the intergroup Ewing’s sarcoma study[J]. Cancer, 1983, 51(6): 1021-1027.
[16]Moser RP, Davis MJ, Gilkey FW, et al. Primary Ewing Sarcoma of Rib[J]. RadioGraphics, 1990, 10(5): 899-914.
[17]朱晓峰，徐宗云，张尧杰，等. 肋骨尤文肉瘤并肺转移1例[J]. 黑龙江医药科学，2002，25（3）：104.
[18]贺晓武，张菊蓉. 胸壁脊索瘤误诊为转移瘤1例[J]. 人民军医，2006，49（5）：309.
[19]梁海红，尹全乐. 副脊索瘤1例[J]. 河北医药，2014，36（19）：3036-3037.
[20]Nishiyama N, Nakatani S, Inoue K, et al. Primary lymphoma of bone originating in a rib[J]. Jpn J Thorac Cardiovasc Surg, 2000, 48(3): 180-183.
[21]Purohit S, Bhise R, Jaipal BR, et al. An Unusual Presentation of Primary Rib Non Hodgkins Lymphoma Masquerading as Male Breast Cancer[J]. Indian J Surg Oncol, 2012, 3(4): 308-310.
[22]Teitelbaum SL. Tumors of the chest wall[J]. Surg Gynecol Obstet, 1969, 129(5): 1059-1073.
