case_images: PMC11774699_01
case_images: (A1, A2) Enhanced CT lung window images showing the expansile, osteolytic destruction of the left 6th rib, accompanied by soft tissue mass formation. Multiple patchy and arc-like calcifications and internal septations are visible. The red arrows point to the area of the rib destruction and the soft tissue mass. (B) Enhanced CT mediastinal window image demonstrating destruction of the left 6th rib and associated soft tissue mass, with heterogeneous enhancement. The red arrow highlights the region of the rib damage and the mass's heterogeneity. (C1) Preoperative bedside frontal chest X-ray showing symmetrical thoracic structures, centered trachea and mediastinum, and expansile destruction of the left 6th rib, with soft tissue swelling and increased lung markings. The red arrow indicates the expansile destruction area of the 6th rib. (C2, C3) Postoperative bedside frontal and lateral chest X-rays showing partial absence of the left 6th rib, chest tube in the left pleural cavity, and soft tissue swelling with gas in the left chest wall as postoperative changes.
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case_images: Figure 1C ). Further chest CT examination revealed bone destruction of the left 6th rib, accompanied by a soft tissue mass measuring approximately 68x119x93 mm. Enhanced CT images demonstrated heterogeneous enhancement of the mass, with destruction of the left 6th rib and adjacent soft tissue involvement ( Figures 1A, B ).
case_images: (A) MRI of the back and chest soft tissues showing expansile destruction of the left 6th rib, with an abnormal soft tissue mass in the adjacent pleural cavity. The mass appears heterogeneous on T1WI and T2-fat suppressed sequences. The red arrow marks the location of rib destruction and adjacent soft tissue mass. (B) Coronal MRI image showing a large soft tissue mass adjacent to the rib, with cystic degeneration and necrosis. The red arrow circles the cystic and necrotic area within the soft tissue mass. (C) Axial MRI image demonstrating the lesion compressing adjacent structures, including the left lung, diaphragm, and spleen. The red arrow points to the region of compression caused by the lesion.
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case_images: Coronal MRI images revealed cystic degeneration and necrosis within the mass, compressing adjacent structures such as the left lung and diaphragm ( Figures 2A-C ).
case_images: (A) Pathological section of the surgical specimen showing tumor tissue composed of spindle-shaped tumor cells and osteoclast-like giant cells, with significant cellular atypia and partial osteogenesis. (B) Pathological section showing a multi-cystic structure within the tumor tissue, with blood clots in the cysts and high mitotic activity, indicative of high-grade malignancy. (C) Pathological section showing cystic areas infiltrated by numerous spindle-shaped tumor cells and necrosis, consistent with features of a malignant giant cell tumor of bone.
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case_images: Pathological sections demonstrated tumor tissues with prominent cellular atypia, cystic degeneration, and necrosis ( Figures 3A-C ).
case_images: Timeline of key events in the diagnosis, treatment, and follow-up of the patient. This timeline summarizes the major clinical milestones for a 19-year-old female patient with a malignant giant cell tumor of the left 6th rib. Key events include the discovery of an abnormal chest lesion during routine university admission screening in August 2024, surgical resection and pathological confirmation of the diagnosis on August 28, 2024, pathology consultations in September 2024 that verified the diagnosis, and follow-up imaging and physical examinations in October 2024 showing no signs of recurrence.
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case_images: A timeline summarizing key events, including diagnosis, treatment, and follow-up milestones, is presented in  Figure 4  to provide a clear chronological overview of the patient's clinical course.