Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2023; 11(17): 4123-4132
Published online Jun 16, 2023. doi: 10.12998/wjcc.v11.i17.4123
Chest wall osteochondroma resection with biologic acellular bovine dermal mesh reconstruction in pediatric hereditary multiple exostoses: A case report and review of literature
Abdullah Alshehri
Abdullah Alshehri, Department of Surgery, College of Medicine, King Saud University, Riyadh 11623, Saudi Arabia
Author contributions: Alshehri A was the patient’s primary surgeon and wrote and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the guardians of the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The author declares that he has no conflicts of interest to disclose.
CARE Checklist (2016) statement: The author has read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdullah Alshehri, FRSC, MBBS, MSc, Assistant Professor, Surgeon, Department of Surgery, College of Medicine, King Saud University, King Khalid Road, Riyadh 11623, Saudi Arabia. abalshehri@ksu.edu.sa
Received: March 22, 2023
Peer-review started: March 22, 2023
First decision: April 19, 2023
Revised: May 2, 2023
Accepted: May 12, 2023
Article in press: May 12, 2023
Published online: June 16, 2023
Processing time: 81 Days and 19.9 Hours
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.