A tumor of the first rib was accidentally discovered by X-ray examination in a 36-year-old female patient. Following preoperative scintigram, angiogram, and computed tomography, transaxial en bloc resection of the first rib and reimplantation of the subclavian artery into the aortic arch was performed.
Histological examination revealed a rare fibrous dysplasia of the first rib, and a malignant tumor could be excluded. Surgical treatment was indicated by the differential diagnoses “osteosarcoma,”“osteoblastoma,” and “chondrosarcoma.”Experience with transaxial resection of the first rib for treatment of thoracic outlet syndrome has proved to be very helpful in performing en bloc resection for this indication. It should be kept in mind that vascular reconstruction might be required.