Mimicking rib osteochondroma as pulmonary nodule in a pediatric patient: A case report from Damascus, Syria

Osteochondromas, the most frequent type of bone tumor, develop from the metaphysis region of bones. Osteochondroma often occurs in bones, however, it is rare when it comes to rib tumors. It is often asymptomatic and observed incidentally. We present a case of a 14-year-old male patient who had been experiencing cough and mild fever for approximately a week. We requested a CXR PA and LAT. It showed a pulmonary nodule measuring 1.5 cm in diameter in the upper segment of the left lower lobe. Taking into account the unclear nature of the diagnosis, we requested CT scan with contrast of the chest to obtain a better view. It showed: The nodule visualized on the CXR corresponded to a posteriorly directed, well-defined lesion arising from the costal cartilage of the third left rib, measuring 1.2 × 1.3 × 1.1 cm, likely representing an osteochondroma. The case we discussed highlights a rib osteochondroma that initially seemed like a pulmonary nodule on an X-ray, pointing out the importance of using CT scans for accurate diagnosis in such cases, and reminding us to consider osteochondroma when we see similar symptoms and to regularly check the tumor with medical imaging after it's been confirmed by a pathological test.