Giant chondrosarcoma of the chest wall: a rare surgical challenge

Brito, Íris M; Teixeira, Sérgio; Paupério, Gonçalo; Choupina, Hugo Miguel Pereira; Ribeiro, Matilde

doi:10.4322/acr.2020.166

Cited by 5 publications

(6 citation statements)

References 19 publications

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“…Most cases arise de novo (primary) within the medullary cavity, however, some cases may result from malignant transformation (secondary) of preexisting benign cartilaginous tumors [1] . Chondrosarcoma is more common in the elderly from the sixth decade of life with slight male predominance [11] . A previous history of local trauma or radiotherapy is not uncommon and can be associated with thoracic chondrosarcoma [1,11] , however, in our patient, there was no evidence of such events.…”

Section: Discussionmentioning

confidence: 99%

“…Chondrosarcoma is more common in the elderly from the sixth decade of life with slight male predominance [11] . A previous history of local trauma or radiotherapy is not uncommon and can be associated with thoracic chondrosarcoma [1,11] , however, in our patient, there was no evidence of such events. In several previous reports, both chondrosarcoma and chondromyxoid fibroma had been confused for each other due to the similarities in the radiological and histological findings.…”

Section: Discussionmentioning

confidence: 99%

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A diagnostic dilemma: A dorsal spine chondromyxoid fibroma turned out to be chondrosarcoma

Alswerki¹,

Elifranji²,

Hadidi³

et al. 2022

Int. J. Case Rep. Orthop.

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Introduction: Chondrosarcoma is the most common malignant primary tumor of the chest wall. Only a few cases were reported to arise posteriorly from the paravertebral component. Case presentation: In this case report, we present a case of chondrosarcoma, a rare bony tumor which was misdiagnosed with chondromyxoid fibroma in 50 years old male patient. The patient presented with left loin pain with no radiation. The patient underwent radiological imaging and computed tomography guided biopsy, results showed chondromyxoid fibroma, which turned out to be chondrosarcoma on post-operative histopathological examination of the excised tumor. The patient underwent surgical excision of the lesion, with improvement of his symptoms. Conclusion: Despite its rarity, this tumor can be misdiagnosed with chondromyxoid fibroma. Overlapping radiological and histopathological features can make diagnosis difficult with unsatisfactory surgical excision margins. Hence, an extensive pre-operative evaluation and adequate tissue sampling can help avoiding this confusion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A diagnostic dilemma: A dorsal spine chondromyxoid fibroma turned out to be chondrosarcoma

Alswerki¹,

Elifranji²,

Hadidi³

et al. 2022

Int. J. Case Rep. Orthop.

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“…This is an unusual presentation seen in 6.5% of individuals who have what looks like an intrathoracic mass without a pre-existing lesion, suggesting a primary etiology in origin. [ 1 6 ]…”

Section: Discussionmentioning

confidence: 99%

“…Chondrosarcoma is a common malignant tumor that arises in the pelvis or long bones, but its presence in the ribs is uncommon, with an incidence of 0.5 per million person-years. [ 1 ] They represent 20% of all chest wall neoplasms. [ 2 ] Contrast-enhanced computed tomography is the gold standard investigation of choice for appropriate diagnosis and operative planning.…”

Section: Introductionmentioning

confidence: 99%

Chondrosarcoma of the rib: Atypical presentation and management

Dantis

Kashyap

Thakur

et al. 2021

J West Afr Coll Surg

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Chondrosarcoma is an uncommon malignant tumor of the rib and can have an atypical presentation based on age, gender, and clinical manifestation with differential diagnosis of intrathoracic mass. Management is surgical as the tumor is resistant to chemoradiation. Access to chest wall reconstruction is limited in many low-income countries and forms a barrier to patient compliance. We report an atypical presentation and describe a simple, easy, and cost-effective chest wall reconstruction method for chondrosarcoma of the rib in any resource-constrained setting.

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“…The gold standard for diagnosing chondrosarcoma is the CT scan, which provides detailed insights into the distinctive features of this tumor. These imaging studies reveal a well-defined, lobulated soft-tissue mass with a calcified chondroid matrix, facilitating accurate identification and assessment [ 4 ]. However, the diagnostic journey extends beyond imaging, as exemplified by our presented case.…”

Section: Introductionmentioning

confidence: 99%

Chondrosarcoma of the Sternum: Surgical Challenges, Chest Wall Reconstruction, and Postoperative Management

Trepić,

Nemet,

Ergelašev

2024

Cureus

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Although rare, primary chondrosarcoma is the most frequent malignant tumor of the sternum. It commonly manifests as a painful, expanding mass arising from the costochondrosternal junction. Since it is resistant to radiotherapy and chemotherapy, surgical resection with reconstruction is the preferred treatment. A 50-year-old male presented with swelling over the left fourth sternocostal joint, gradually increasing in size. Imaging and clinical assessment suggested an infiltrative neoplasm, and surgical resection was indicated. The patient underwent a partial sternectomy, including a resection of the xiphoid process and costal cartilages two to seven and a partial resection of the manubrium. Postoperative pathohistological analysis specified the change as a low-grade chondrosarcoma in the pT1 stage. Chest wall reconstruction involved three pectus bars fixated around the ribs and the placement of a synthetic polypropylene mesh. The patient required postoperative rehospitalization due to partial skin layer wound dehiscence, serous drainage, and fever. Empirical antibiotic therapy was initiated, and the patient underwent a median superior laparotomy with partial omentoplasty of the sternal region, preserving the mesh and pectus bars. A culture analysis revealed methicillin-resistant Staphylococcus epidermidis , and postoperative antibiotic therapy was adapted to the antibiogram. Subsequently, all parameters of inflammation decreased, and wound healing followed. A one-year follow-up CT scan showed no disease recurrence. This case highlights the intricate surgical management that contributed to the successful treatment of sternal chondrosarcoma. Sternal wound infection, a severe postoperative complication with a high mortality rate, requires prompt identification, precise revision with culture-directed antibiotics, and effort to preserve the prosthetic material.

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Giant chondrosarcoma of the chest wall: a rare surgical challenge

Cited by 5 publications

References 19 publications

A diagnostic dilemma: A dorsal spine chondromyxoid fibroma turned out to be chondrosarcoma

A diagnostic dilemma: A dorsal spine chondromyxoid fibroma turned out to be chondrosarcoma

Chondrosarcoma of the rib: Atypical presentation and management

Chondrosarcoma of the Sternum: Surgical Challenges, Chest Wall Reconstruction, and Postoperative Management

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