Chest wall osteochondroma resection with biologic acellular bovine dermal mesh reconstruction in pediatric hereditary multiple exostoses: A case report and review of literature

Abstract

BACKGROUND

Hereditary multiple exostoses is a rare genetic disorder characterized by the growth of multiple osteochondromas affecting primarily long bones. Chest wall lesions may represent a challenge, particularly in pediatric patients. Pain is a common manifestation. However, life-threatening complications can result from direct involvement of adjacent structures. Surgical resection with appropriate reconstruction is often required.

CASE SUMMARY

A 5-year-old male who was diagnosed with hereditary multiple exostoses presented with significant pain from a large growing chest wall exostosis lesion. After appropriate preoperative investigations, he underwent surgical resection with reconstruction of his chest wall using a biologic bovine dermal matrix mesh.

CONCLUSION

Resection of chest wall lesions in children represents a challenge. Preoperative planning to determine the appropriate reconstruction strategy is essential.

Keywords: Hereditary multiple exostoses; Chest wall neoplasm; Chest wall reconstruction; Biologic mesh; Pediatric; Case report

Core Tip: Hereditary multiple exostoses is an uncommon genetic musculoskeletal disorder characterized by multiple skeletal lesions (exostoses). Although most lesions are asymptomatic, pain is a frequent patient complaint. Additionally, life-threatening complications may occur secondary to direct involvement of adjacent structures. Our patient had several skeletal lesions with a large chest wall exostosis causing significant pain and disability. Resection was successfully performed with chest wall reconstruction using a biologic mesh derived from acellular bovine dermis. For similar cases, careful patient selection, proper perioperative planning, and appropriate reconstruction strategy are important factors to achieve the desired outcome.