Reconstruction of Chest Wall by Cryopreserved Sternum Allograft After Resection of Sternal Hemangioma: A Case Report

Beigee, Farahnaz Sadegh; Sheikhy, Ali; Sheikhy, Kambiz

doi:10.3389/fsurg.2022.796806

Cited by 1 publication

(2 citation statements)

References 21 publications

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“…Among these lesions we find both sternal invasion from adjacent diseases such as breast or mediastinal tumors (thymic carcinoma, germ cell tumors and others) as well as purely metastatic lesions. Among the latter, breast cancer is usually the most frequent with up to 50% incidence in some series ( 7 ) but other possible metastatic tumors are solitary plasmacytoma ( 8 ), renal cell cancer ( 9 ), melanoma ( 10 ), thyroid carcinoma ( 11 ), colorectal cancer, cervical cancer, hemangioma ( 12 ) or hepatocellular carcinoma ( 13 ). Given their overall low incidence and therefore limited published data, there is no consensus on their treatment ( 13 ), though given their bad prognosis and the high rate of incomplete resections performed the trend is towards limited palliative exeresis to avoid pain, infection or pulmonary function impairment, always within a multimodal treatment scheme ( 7 ).…”

Section: Indications For Sternal Resection ( Table 1 ...mentioning

confidence: 99%

“…Sometimes the effort to preserve the upper portion of the sternum to minimize a possible functional alteration carries a high risk of recurrence due to positive surgical margins, so when in doubt a complete resection for oncological benefits is strongly advised ( 39 ). Another particular case for reconstruction is children, where complications related to prosthetic materials and their probable growth restriction make bone grafts and biological meshes specially preferred although again no studies reporting mid-long term results are available ( 12 ).…”

Section: Reconstruction Techniquesmentioning

confidence: 99%

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Sternal resection and reconstruction: a review

Aranda,

Gomez,

Fuentes

et al. 2024

J Thorac Dis

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Sternal resection and reconstruction is a rare but sometimes challenging procedure due to its profound anatomical and functional implications. For these reasons, an adequate preoperative evaluation is crucial in each patient, especially when we are faced with malignant lesions that sometimes require extensive radical resections, thus demanding an integrated reconstructive strategy that allows stabilizing the chest wall, protecting the underlying mediastinum and minimize resulting deformity. The large number of available reconstruction techniques and the lack of quality studies for their analysis mean that sternal reconstruction depends to a great extent on the consensus of experts or, more frequently, on the simple preference of each surgical team. This article aims to provide an overview of sternal resection and reconstruction. Indications for partial versus total or subtotal sternectomy are suggested and their surgical and oncological outcomes are presented. The use of rigid or semi-rigid prostheses is an ongoing debate, although recent functional data advise reserving rigid reconstructions for extensive defects. Sternectomy for primary tumors or local tumor involvement has a good prognosis with an overall survival of 5 and 10 years: 67% and 58%, respectively, provided that a radical resection with free surgical margins is performed. Breast cancer is the most common secondary sternal tumor, and surgery can offer 5-year overall survival ranging from 20% to 50% provided an R0 resection is achieved, although radical surgery does not appear to decrease rates. of recurrence. Metastases of origin other than the breast give the worst results (less than 40% at 36 months and 0% at 5 years) and although the data available on these cases are limited, the radicality of the resection does not seem to modify the survival or recurrence rates, so a conservative approach is probably more appropriate.

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