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Intrathoracic neurogenic tumors arising from chest wall are generally rare tumors. The benign soft tissue tumors may produce compression effect on the chest wall but are generally free. The presence of unusual adherence raises the suspicion of malignancy. Our case report describes the clinical features of a young male who underwent excision of a left posterosuperior chest wall mass with a portion of the fourth rib. Histopathological examination unexpectedly revealed the existence of two different pathologies. The mass was found to be benign schwannoma and the rib showed features of tuberculous osteomyelitis. Inflammatory response and fibrous reaction mimicked the features of malignancy.

Chronic instability of anterior chest wall is a known complication following the minimally invasive right parasternal approach for valvular heart operations. The exact incidence of this condition, as well as the need for reoperation, has not been well documented. We report the first case of successful correction of unstable anterior chest wall in a 33-year-old lady after she underwent atrial septal defect closure through right paramedian approach eight years ago. The repair consisted of interposing iliac crest bone graft in the defect created by deficiency of the 3rd and 4th costal cartilages and anchoring the graft using steel wires.

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Unusual tumors of the mediastinum constitute less than 10% of all mediastinal masses. The majority of these are mesenchymal in origin. Rarely tumors of the spine such as aneurysmal bone cyst may gain entry into the thoracic cavity and grow exuberantly, thus mimicking a malignant mediastinal mass. The relative lack of resistance and the negative intrathoracic pressure favor the expansile growth characteristic of such a tumor. Preoperative recognition is essential for correct surgical decision making. (Ind J Thorac Cardiovasc Surg, 2007; 23: 260-262)