Resection and primary reconstruction of a massive chest wall chondrosarcoma

Abstract

Primary malignant tumours of the chest wall are among the rarest cartilaginous tumours. Chondrosarcomas present a difficult clinical problem due to its high resistance to conventional chemotherapy and radiotherapy. Complete surgical resection has been the cornerstone for treatment. It has been associated with better prognosis, survival and less recurrence in contrast to other methods of therapy. Patients with chondrosarcomas generally have a good prognosis when surgical resection is performed. Improvement in outcomes is seen when patients are evaluated in a multidisciplinary care facility. We present the case of a 66-year-old male patient that exhibits a chest wall mass diagnosed as a chondrosarcoma. After chemotherapy failure, our patient was successfully treated with complete surgical excision of the mass. Final tissue biopsy report was remarkable for a p53 gene mutation, which is known to be associated with tumour progression and loss of growth control.

Case report on the approach to surgical management for a large chest wall chondrosarcoma

“…Chest wall reconstruction done with synthetic polypropylene mesh and local muscle flaps can be performed as a safe, effective one-stage surgical procedure for a variety of major chest wall defects [16] . The 5-year survival rate after resection with adequate surgical margins (4 cm on each side) was 100% compared with 50% in patients with inadequate surgical margins [19] . This group also had local recurrence rates of 15 to 25%.…”