ABSTRACT Osteochondroma is the most common benign cartilage tumor. Although, most lesions are asymptomatic, life-threatening conditions caused osteochondromas have been reported in the literature such pneumothorax, hemothorax, diaphragmatic rupture, and lung injury. We report a case of a thirty year old male who presented with shortness of breath and was found to have a pneumothorax on chest X-ray. Subsequent Computed Tomography of the chest revealed a 1.3 cm growth on the posterior portion of the fourth right rib protruding into the right middle lobe. The patient underwent thoracoscopic resection of the lesion along with a wedge resection of the right middle lobe. The rib was reconstructed using a metal plate. He remains asymptomatic without recurrence on a one year follow up.
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