# Costal Osteoid Osteoma: A Case Report and Review of the Literature

## TL;DR

A rare case of a benign tumor in the rib is reported, highlighting the difficulty in diagnosing it due to unclear symptoms and initial imaging results.

## Contribution

This case report adds to the limited literature on costal osteoid osteoma and highlights its diagnostic challenges.

## Key findings

- Initial radiographs were normal, but CT and bone scintigraphy identified a rib lesion.
- Surgical resection confirmed the diagnosis of osteoid osteoma.
- The patient experienced persistent neuropathic pain after surgery.

## Abstract

Costal osteoid osteoma is a rare benign tumor that can be diagnostically challenging due to its atypical location and nonspecific symptoms. We report the case of a 49-year-old male presenting with chronic right-sided chest wall pain for three years. Initial radiographs were normal, but CT imaging and bone scintigraphy later revealed a focal lesion on the ninth right rib. Surgical resection was performed, confirming the diagnosis histologically. The patient subsequently developed persistent moderate intercostal neuropathic pain. This report illustrates the diagnostic pitfalls of rib-localized osteoid osteoma, particularly when initial imaging is inconclusive, and emphasizes the importance of considering this rare entity in patients with unexplained chronic thoracic pain.