Giant bilateral fibrous dysplasia of first ribs: compression of mediastinum and thoracic outlet

A 43 year old woman presented with two large bilateral tumours of the first ribs that compressed the right subclavian vessels, trachea and oesophagus and led to right arm oedema, severe dyspnoea and dysphagia. The resected tumours showed typical histological features of fibrous dysplasia without malignant transformation. The right tumour weighed 1.5 kg and measured 17 x 13 x 10 cm. This report demonstrates that major surgery is still possible for resection of such exceptional giant compressive lesions, since fibrous dysplasia is a benign and non-infiltrative tumour.