Giant cell tumors that originated in the sternum

Abstract

Giant cell tumors originating from the sternum are rare. We report a case of a giant cell tumor of the sternum with radiological evidence of aggressiveness. A 34 year-old woman noted a mass in the anterior chest wall that had been slowly growing over 1 year. After incision biopsy revealed a diagnosis of a giant cell tumor she was treated by surgical resection (subtotal sternectomy) and reconstruction with methylmethacrylate. The tumor was 14×9×8 cm, and histological study confirmed that it was a giant cell tumor. Although giant cell tumors are benign, they are locally aggressive lesions and must be considered in the differential diagnosis in patients with a sternal mass.

Surgical management of rare benign tumors of the sternum

“…Fine-needle aspiration is insufficient for the diagnosis of chest wall tumors,and incisional biopsy is required for the accurate morphologic diagnosis of GCT. 14 , 17 , 20 , 21 The immunohistochemical stains for vimentin, S100, pancytokeratin, desmins, and smooth muscle antigen can be useful in uncertain cases. 11 …”

“…The extent of resection depends on the tumor location, and subtotal sternectomy is the most common procedure. 6 , 7 , 11 , 13 , 17 , 21 Futani et al 14 reported extended curettage of the tumor followed by filling of the defect with polymethyl methacrylate (PMMA) with no recurrence observed 7 years after surgery. Similarly, Segawa et al 19 completed the chest wall reconstruction after curettage and cement usage with polypropylene mesh and a titanium mesh plate.…”

“…Only 16 cases with a morphologically confirmed diagnosis have been described in the literature (Table 1). 6,7,[11][12][13][14][15][16][17][18][19][20][21][22] Gupta et al 15 analyzed histopathological features of 470 GCTs of bone diagnosed over 20 years. In this review, only one patient (0.21%) had a sternal tumor.…”

“…23 Fine-needle aspiration is insufficient for the diagnosis of chest wall tumors,and incisional biopsy is required for the accurate morphologic diagnosis of GCT. 14,17,20,21 The immunohistochemical stains for vimentin, S100, pancytokeratin, desmins, and smooth muscle antigen can be useful in uncertain cases. 11 Surgical resection remains the only radical treatment option for sternal GCT despite successful bisphosphonate therapy and radiotherapy in selected patients with GCT of the bone.…”

A biomechanical study of relationship between sternum defect patterns and thoracic respiration

“…However, there are situations, where the team has to play without this important member. In some clinical cases, partial or total resection of the sternum is needed to remove tumors invading the sternum, [1][2][3][4][5] or to treat osteomyelitis of the sternum. [6,7] In these situations, the thoracic respiration can be negatively affected because the connection of bilateral thoraces though the sternum is impaired.…”