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28 September 2012

Chondrosarcoma from the sternum: Reconstruction with titanium mesh and a transverse rectus abdominis myocutaneous flap after subtotal sternal excision

Kazutaka KotoBCDEF, Tomoya SakabeABDF, Naoyuki HorieB, Kazuteru RyuB, Hiroaki MurataAC, Shinichiro NakamuraAB, Toshihiro IshidaB, Eiichi KonishiB, Toshikazu KuboG

DOI: 10.12659/MSM.883471

Med Sci Monit 2012; 18(10): CS77-81

Abstract

Background: Chondrosarcoma arising from the sternum is extremely rare and is often untreatable. Removal of the sternum for malignant tumor results in large defects in bone and soft tissue, causing deformity and paradoxical movement of the chest wall and making subsequent repair of the thorax very important. We report a very rare patient with a chondrosarcoma of the sternum who underwent case chest wall resection, followed by reconstruction using a titanium mesh covered with a transverse rectus abdominis myocutaneous (TRAM) flap.
Case Report: A 63-year-old man was referred to our hospital with progressively enlarged swelling of his anterior chest wall. Physical examination showed a 2.5×2.0 cm mass fixed to the sternum, which was diagnosed as a chondrosarcoma based on clinical findings, imaging characteristics and incision biopsy results. The patient underwent a subtotal sternal and chest wall resection to remove the tumor, followed by reconstruction with a titanium mesh and a TRAM flap. There were no complications associated with surgery.
Conclusions: We report an extremely rare case of a patient who underwent subtotal sternal resection, followed by reconstruction, for a large chondrosarcoma. The elasticity and rigidity provided by the titanium mesh and the complete coverage of the surgical wound by a TRAM flap suggest that these procedures may be useful in reconstructing large defects in the chest wall.

Keywords: Rectus Abdominis - surgery, Sternum - surgery, Reconstructive Surgical Procedures - methods, Magnetic Resonance Imaging, Chondrosarcoma - surgery, Surgical Flaps, Surgical Mesh, Titanium - pharmacology

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750