Radical resection and reconstruction of a large sternal chondrosarcoma
Introduction. Primary malignant tumors of the sternum are rare, with chondrosarcoma being the most common primary malignant tumor of the chest. The gold standard in treatment is surgical treatment with wide resection margins, where the rigidity of the chest wall must be ensured, with protection of i...
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| Format: | Article |
| Language: | English |
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Serbian Medical Society
2024-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | https://doiserbia.nb.rs/img/doi/0370-8179/2024/0370-81792400005G.pdf |
| _version_ | 1797215489826488320 |
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| author | Garabinović Željko Savić Milan Čolić Nikola Stojičić Milan Zagorac Slaviša |
| author_facet | Garabinović Željko Savić Milan Čolić Nikola Stojičić Milan Zagorac Slaviša |
| author_sort | Garabinović Željko |
| collection | DOAJ |
| description | Introduction. Primary malignant tumors of the sternum are rare, with chondrosarcoma being the most common primary malignant tumor of the chest. The gold standard in treatment is surgical treatment with wide resection margins, where the rigidity of the chest wall must be ensured, with protection of internal organs with satisfactory lung function. Case outline. We present a 67-year-old patient in whom previous computed tomography and magnetic resonance imaging examinations confirmed a tumor mass involving the sternum with the associated ribs, with involvement of the soft tissues above. First, sternum resection was performed with partial resection of the associated ribs and soft tissues. Reconstruction and stabilization of the chest wall were achieved with two layers of polypropylene mesh and methyl methacrylate bone cement with antibiotics. We reconstructed the primary soft tissue defect with a combination of a large local fasciocutaneous flap raised from the abdomen and a smaller sliding flap from the chest. The secondary defect was reconstructed by wide undermining of the skin in the area of the anterior abdominal wall and a small Thiersch-type free skin graft. In the postoperative period, the flaps were vital, but there was necrosis of the free skin graft. That defect was closed secondary thanks to bandaging. Respiratory function was preserved. Conclusion. Surgical treatment is the main treatment for sternal chondrosarcoma. With an adequate preoperative and intraoperative approach, it is necessary to enable good postoperative oncological outcomes with the achievement of chest rigidity and satisfactory respiratory status. |
| first_indexed | 2024-04-24T11:30:53Z |
| format | Article |
| id | doaj.art-5bba176462544335b14dc944761ec728 |
| institution | Directory Open Access Journal |
| issn | 0370-8179 2406-0895 |
| language | English |
| last_indexed | 2024-04-24T11:30:53Z |
| publishDate | 2024-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-5bba176462544335b14dc944761ec7282024-04-10T10:20:17ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792406-08952024-01-011521-2677010.2298/SARH231018005G0370-81792400005GRadical resection and reconstruction of a large sternal chondrosarcomaGarabinović Željko0https://orcid.org/0009-0007-7671-1713Savić Milan1Čolić Nikola2https://orcid.org/0000-0001-6516-1970Stojičić Milan3https://orcid.org/0000-0002-4545-4335Zagorac Slaviša4University Clinical Center of Serbia, Clinic for Thoracic Surgery, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaUniversity Clinical Center of Serbia, Clinic for Thoracic Surgery, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaUniversity Clinical Center of Serbia, Center for Radiology and Magnetic Resonance Imaging, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Belgrade, Serbia + University Clinical Center of Serbia, Clinic for Burns, Plastic and Reconstructive Surgery, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Belgrade, Serbia + University Clinical Center of Serbia, Orthopedic and Traumatology Clinic, Belgrade, SerbiaIntroduction. Primary malignant tumors of the sternum are rare, with chondrosarcoma being the most common primary malignant tumor of the chest. The gold standard in treatment is surgical treatment with wide resection margins, where the rigidity of the chest wall must be ensured, with protection of internal organs with satisfactory lung function. Case outline. We present a 67-year-old patient in whom previous computed tomography and magnetic resonance imaging examinations confirmed a tumor mass involving the sternum with the associated ribs, with involvement of the soft tissues above. First, sternum resection was performed with partial resection of the associated ribs and soft tissues. Reconstruction and stabilization of the chest wall were achieved with two layers of polypropylene mesh and methyl methacrylate bone cement with antibiotics. We reconstructed the primary soft tissue defect with a combination of a large local fasciocutaneous flap raised from the abdomen and a smaller sliding flap from the chest. The secondary defect was reconstructed by wide undermining of the skin in the area of the anterior abdominal wall and a small Thiersch-type free skin graft. In the postoperative period, the flaps were vital, but there was necrosis of the free skin graft. That defect was closed secondary thanks to bandaging. Respiratory function was preserved. Conclusion. Surgical treatment is the main treatment for sternal chondrosarcoma. With an adequate preoperative and intraoperative approach, it is necessary to enable good postoperative oncological outcomes with the achievement of chest rigidity and satisfactory respiratory status.https://doiserbia.nb.rs/img/doi/0370-8179/2024/0370-81792400005G.pdfsternal chondrosarcomasurgical treatmentreconstruction |
| spellingShingle | Garabinović Željko Savić Milan Čolić Nikola Stojičić Milan Zagorac Slaviša Radical resection and reconstruction of a large sternal chondrosarcoma Srpski Arhiv za Celokupno Lekarstvo sternal chondrosarcoma surgical treatment reconstruction |
| title | Radical resection and reconstruction of a large sternal chondrosarcoma |
| title_full | Radical resection and reconstruction of a large sternal chondrosarcoma |
| title_fullStr | Radical resection and reconstruction of a large sternal chondrosarcoma |
| title_full_unstemmed | Radical resection and reconstruction of a large sternal chondrosarcoma |
| title_short | Radical resection and reconstruction of a large sternal chondrosarcoma |
| title_sort | radical resection and reconstruction of a large sternal chondrosarcoma |
| topic | sternal chondrosarcoma surgical treatment reconstruction |
| url | https://doiserbia.nb.rs/img/doi/0370-8179/2024/0370-81792400005G.pdf |
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