Sternal resection and reconstruction after renal cell carcinoma metastatic to the sternum

Abstract

the circumflex, a transatrial approach would no doubt be ideal. In cases similar to ours, a direct approach through a left thoracotomy is a good alternative because the circumflex artery can be clearly visualized and protected. Moreover, most patients do not have significant mitral regurgitation and might not require an additional mitral valve procedure.Our approach, which is based on the relationship of the circumflex coronary artery to the neck of the aneurysm as demonstrated on a preoperative angiogram, appears to be safe and will result in significant reduction in mortality and morbidity in managing this rare and difficult condition, particularly in parts of the world outside Africa.

Sternal resection of a solitary renal cell carcinoma metastasis: a case report and a literature review

“…The literature reported two cases of radical nephrectomy, sternal tumour resection, and reconstruction as one-stage procedures. Pyle with colleagues wrote of their experience performing nephrectomy and sternal resection/reconstruction with a Prolene methylmethacrylate sandwich for a 2.2 × 4.5 cm sternal metastasis of renal cell carcinoma (16). They also continued with local radiation to the chest wall together with systemic immunotherapy.…”

“…For example, isolated metastasis to the sternum is considered a rare condition (8). In the literature review, only a few cases of RCC with a solitary sternal metastasis were reported (3,(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

Painless pulsatile mass as first presentation of renal cell carcinoma

“…2 There are a few cases reported in the literature of patients with sternal metastases and renal cell carcinoma who underwent nephrectomy and sternal resection, which resulted in patients being asymptomatic up to 5 years postoperatively. 6 We also had another patient who had a nephrectomy for renal cell carcinoma, as well as radiotherapy for a sternal metastasis, diagnosed histologically following biopsy, and the patient has been recurrence free for the last eight years. Although this has been shown to potentially improve survival and quality of life 7 , unfortunately our current patient was unfit for treatment due to pre-existing co-morbidities, and has now sadly passed away.…”

Can surgery relieve pain and act as first-line treatment for a large metastasis of the sternum?

“…The sternum metastasis is a relatively rare site and it often manifests as swelling of the sternal region, pain or a sensation of tension [4,5]. There are few papers published on sternal metastasis of renal cell carcinoma [[1], [2], [3], [4], [5], [6], [7], [8]]. Aim of our report is to describe a case of a large and painful tumor mass infiltrating the sternal manubrium, undergone radiotherapy for reducing pain with no resolution.…”