Simultaneous Video Assisted Thoracoscopic Costal and Femoral Osteochondromas Resection in a Child with Multiple Exostoses Disease: A Case Report and Literature Review

Abstract

The case reported concerns a 5-years-old child affected by Hereditary Multiple Exostoses (HME), a genetic disorder with autosomal dominant inheritance, that cause multiple skeletal exostosis. Usually those masses are asymptomatic, but in some cases, they can cause a huge spectrum of problems due to their size and site localization interfering with surrounding structures such as nerves, vessels, or organs. In order to reduce patient distress and hospital stay we resected in the same surgical session, an exostosis on the left knee (that was interfering with the correct bone growth) and, with video-assisted-thoracoscopy (VATS), three rib exostosis (one of them misdiagnosed at the MRI examination).. Temporary femoral hemiepiphysiodesis was performed too in order to correct the knee valgus malalignment. In case of exostosis localized at the internal side of the ribs, the collaboration of a skilled pediatric surgeon is recommended to perform VATS resection. common in the setting of multiple hereditary osteochondromato-