Preserving the posterior cortex of the sternum during resection of a superficial anterior chest wall sarcoma

Abstract

Following resection of a sternal tumor, respiratory dysfunction can occur and rigid reconstruction is necessary. An 82-year-old woman noted a mass in the anterior chest wall that was increasing in size. The tumor was located on the left aspect of the sternum at the level of the third rib. A radiation-induced malignant spindle cell tumor was diagnosed because of a history of irradiation for hilar lymph node carcinoma. The tumor was resected with the surrounding tissues of the second-to-fourth ribs and sternum. The posterior sternal cortex was preserved by cutting with a curved chisel under fluoroscopy. The chest wall defect was reconstructed with a 2-mm thick Gore-Tex® sheet and a local transpositional flap. Sternal resection with a chisel under fluoroscopy avoids damage to the internal thoracic artery. Preserving the posterior sternal cortex does not require rigid reconstruction. The procedure is minimally invasive.

A Novel Surgical Technique for the Management of Large-Volume Neurogenic Heterotopic Ossification Following a Spinal Cord Injury: The Sashimi Technique

“…Previous reports of similar uses are seen in the literature for a use case in osteosarcoma resection of the femur [ 7 ]. Another case was reported in the literature regarding sarcoma resection in the sternum in crucial areas [ 8 ].…”

“…Another case was reported in the literature regarding sarcoma resection in the sternum in crucial areas [8].…”

Sternal resection and reconstruction: a review

“…Partial sternectomies are reserved for more localized tumors ( 4 ). Some authors ( 35 ) have even reported more conservative approaches with preservation of the posterior cortex of the sternum, but in our opinion, since an R0 resection is necessary to avoid the high risk of tumor recurrence and since these supposedly limited resections frequently include skin, soft tissue or ribs excision, its advantages are highly questionable.…”