WOFAPS 2025 8th World Congress of Pediatric Surgery

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Poster Display - 184

Bilateral Chondromesenchymal Hamartoma of the Chest Wall in Children: A Case Report and Surgical Strategy

Oleg Pikin 1, Dmitry Morozov 2, Oleg Topilin 3, Maxim Airapetyan 4, Olga Sukhodolskaya 5
1 Herzen Research Institute of Oncology – Branch of the National Medical Research Radiological Centre
2 Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University
3 Morozov Children's City Clinical Hospital
4 MMCC
5 First Moscow State Medical University named after I.M. Sechenov (Sechenov University)

Background:
Chondromesenchymal hamartoma (CMH) of the chest wall is an exceptionally rare benign tumor originating from ribs, predominantly affecting infants and young children. This lesion typically presents with thoracic tension syndrome and progressive skeletal deformities, including scoliosis. Surgical resection, while necessary, invariably requires rib removal and poses significant challenges in chest wall reconstruction.

Case Presentation:
We report the 15th documented case of bilateral CMH in pediatric patients worldwide. Our multidisciplinary team performed a three-stage surgical resection due to bilateral involvement and continued postoperative tumor growth. The surgical approach incorporated:

  • Advanced 3D modeling and printing for preoperative planning and intraoperative navigation

  • Novel chest wall reconstruction using xenograft pericardial patches

  • Custom-designed prosthetic rib implantation

Results:
The staged surgical intervention achieved complete tumor resection while maintaining thoracic integrity. The combination of xenograft materials and prosthetic rib implantation demonstrated excellent biocompatibility and structural support during follow-up. This approach effectively addressed the dual challenges of radical tumor excision and prevention of thoracic deformity progression.

Conclusion:
This case highlights several critical considerations in pediatric CMH management:

  1. Bilateral presentation requires staged surgical intervention

  2. 3D technologies significantly enhance surgical precision in complex chest wall cases

  3. Hybrid reconstruction using xenograft pericardium and prosthetic ribs offers a viable solution for thoracic stability
    The presented surgical strategy may serve as a paradigm for managing extensive benign chest wall tumors in growing children.

Keywords: chest wall reconstruction, children, chondromesenchymal hamartoma, prosthetic rib, thoracic surgery, xenograft pericardium

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