Sternum tumor surgical treatment method: A clinical case

Abstract

Relevance: Sarcomas are relatively rare. They make up 1% of all malignant neoplasms in adults, of which about 10-15% appear in the chest wall. Unlike primary tumors, metastatic bone tumors occur 2-4 times more often, while the sternum is affected in 9% of all metastatic bone lesions. A review of the literature and analysis of patients with chest wall tumors showed that surgical treatment might be the best option for primary tumors and some secondary chest wall tumors. Chondrosarcoma (12%) is the most common primary chest bone sarcoma and originates from the anterior segment of the ribs, less often from the sternum, scapula, or clavicle.
The purpose was to present the outcome of a sternum sarcoma surgical treatment with a simultaneous reconstruction of an extensive postoperative defect at the Kazakh Institute of Oncology and Radiology (Almaty, Kazakhstan).
Methods: The article reviews the literature on the treatment of chest wall tumors and describes a clinical case of a patient with chondrosarcoma of the sternum. After subtotal resection of the sternum 2-3 cm away from the tumor margins, the patient underwent reconstructive plastic surgery. Synthetic material was used to stabilize the chest wall, prevent paradoxical breathing, and replace the defect.
Result: No recurrence of the main process was registered after radical removal of the sternum tumor with the simultaneous reconstruction of
the defect with synthetic material. Given the prevalence of the tumor, intraoperative suturing of the subclavian vein was performed, which led to vein thrombosis in the postoperative period.
Conclusion: The key to successful sternum tumor treatment is early recognition and radical removal with adequate margins. Complete excision with broadly negative microscopic margins at the first operation is paramount since local recurrence increases the risk of systemic metastasis and death. Thus, standard guidelines are required to ensure chest wall sarcomas proper treatment.