CASE REPORT article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicAdvancing Orthopedic Surgery: unique Case Reports driving progressView all 19 articles
Resection of entire first rib for a malignant tumor via transclavicular approach: A Case Report and Literature Review
Provisionally accepted
- First Hospital, Peking University, Beijing, China
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Abstract Background Malignant tumors of the first rib are extremely rare. Resection of the entire first rib is surgically challenging and requires an ingenious approach due to the complex anatomical characteristics. Currently, there is no standardized surgical approach. We herein report a case of entire first rib resection for a malignant tumor via a transclavicular approach and review relevant literature. Case presentation A 43-year-old Chinese male suffered from right-sided neck and back pain for 1 month. Imaging studies (chest CT, MRI, and PET-CT) revealed an osteolytic lesion with pathological fracture in the right first rib, suggestive of malignancy. Due to the lesion's proximity to critical neurovascular structures, percutaneous biopsy was not feasible. The patient underwent en bloc resection of the entire first rib via a transclavicular approach, which included a V-shaped clavicular osteotomy for exposure, meticulous mobilization and protection of the subclavian vessels and brachial plexus, and subsequent anatomical clavicular reconstruction with a locking plate. The postoperative course was uneventful, with resolution of symptoms and no neurological deficits. Histopathology confirmed lymphoma. Conclusions The transclavicular approach provides excellent exposure for safe and complete resection of first rib tumors, facilitating neurovascular protection and direct visualization. This technique offers a valuable surgical option for selected tumors in this challenging location.
Keywords: first rib tumor, resection, surgical approach, Surgical technique, Transclavicular approach
Received: 11 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Zhao, Sun, Wang and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Taiqiang Yan
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