I don't believe it is Pectus carinatum

Last night when I was saying good night to my 14 yo son, I noticed a buldge at the area of his sternum under his tshirt. I checked it and it is a baseball size hard lump. It is around on the lower sternum around the xyphoid process. I noticed maybe a month ago that he looked "puffy" in that area, and my husband and I felt and really looked at it. It felt a little hard there and irregular, but just a little. It was nothing like it is now.

I called my pediatrician, and he said to take him to the ER. They did a CXR, CT Chest with contrast, and CBC, and SMA7. The lab work was normal. Th CT of chest showed a growth of cartilage and bone in the sternal area but no tumors. They told me it is congenital, and it has just gotten worse since he is "growing".


I am concerned because his height (growth) has not changed since I last measured him (we leave marks on the wall in the family room!), and I KNOW it wasn't like this a month ago. It was as described above, but NO mass. I looked up a congenital abnormality online, and it describes Pectus carinatum as being a pigeon chest or pointed protusion of the sternum. This is a round mass.....no point to it at all.

Also he swallowed a quarter when he was 5 yrs old. He had at least 5 xrays as we waited for it to come out of his stomach. He was only 5...I would have thought that an xray would have showed the sternum, and wouldn't someone have noticed a congenital abnormality before now???

He also had an echocardiogram this past July. He has ADD and had to have a baseline EKG. It showed a right axis deviation so the next step was a echocardiogram. I was told he by the ped cardiologist that had a little congenital blood flow problem, but nothing to worry about and no limitations.
Wouldn't someone have noticed a huge mass on his sternum if it was there just 3 months ago????


He also has a hard pinpoint pimply rash on his arms. He tends to sleep in an upright position...slump over and head resting on his knees. ***zarre. He says it is a little tender at times, but denies pain.

Any ideas? I don't even know where to take him to get it further checked.

thanks!!!

[Dr Vinod]

The problems on the chest can be missed sometimes. As the strernum is obstructing the growth, and the growth has increased in size to protrude out and now you can notice it. As there is no other complication associated with it there is nothing to worry. Go for regualar follow up near a paediatrician and watch for any symptoms.

Pectus carinatum is an overgrowth of cartilage causing the sternum to buckle forward. It may occur as a solitary congenital abnormality or in association with other genetic disorders or syndromes : Marfan syndrome, Morquio syndrome, etc

In about 25% of cases of pectus carinatum, the patient has a family member with the condition.

Take care!