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Sternal reconstruction for unusual chondrosarcoma: innovative technique.

Nosotti M, Rosso L, Mendogni P, Tosi D, Palleschi A, Parafioriti A, Santambrogio L - J Cardiothorac Surg (2012)

Bottom Line: Twelve months after surgery, the patient is in good clinical condition, without any sign of tumor relapse and with normal respiratory mechanics.Primary malignant tumors of the sternum are uncommon and a presentation mimicking thymoma is rare and unreported.The stermal replacement with a cryopreserved allograft sternum is an innovative technique that overcomes the problems related to the prosthetic biocompatibility or to the bone autograft.

View Article: PubMed Central - PubMed

Affiliation: Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, Milan, 20122, Italy.

ABSTRACT
The authors report a clinical case of a primary sternal chondrosarcoma, presented as a mass in the anterior mediastinum. The patient was treated with subtotal sternectomy and sternal transplantation followed by radiotherapy. Twelve months after surgery, the patient is in good clinical condition, without any sign of tumor relapse and with normal respiratory mechanics. Primary malignant tumors of the sternum are uncommon and a presentation mimicking thymoma is rare and unreported. The stermal replacement with a cryopreserved allograft sternum is an innovative technique that overcomes the problems related to the prosthetic biocompatibility or to the bone autograft.

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Related in: MedlinePlus

CT images show the mass into the anterior mediastinum. On the right it is possible to observe the calcified connection between the mass and the sternum; no cortical erosion is present.
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Figure 1: CT images show the mass into the anterior mediastinum. On the right it is possible to observe the calcified connection between the mass and the sternum; no cortical erosion is present.

Mentions: A 71-year-old female was referred to our Unit for anterior thoracic pain associated with a mass of the anterior mediastinum. The CT-scan detected a calcified shadow measuring 10 × 7 cm that suggested a thymoma (Figure 1). The lesion was immediately adjacent to the posterior sternal profile without any erosion of the cortex; on the contrary, one of the calcifications appeared to fusion to the left posterior sternal margin. The PET-scan was silent except for a small focal spot between the mediastinal mass and the right posterior sternal margin, corresponding approximately to the referred pain. The clinical examinations for myasthenia gravis (physical examination, antibodies against the acetylcholine receptor and single fiber electromyography) were negative. We avoided a biopsy of the lesion, considering that the tumors of the anterior mediastinum suspected for thymoma are directly referred to surgery. Keeping in mind the local fusion of the “thymoma” with the sternum and the PET spot suspected for a focal malignancy, cryopreserved allograft sternum and costal cartilage were prepared by the Regional Bank for Muscle and Bone Tissue (Banca Regionale di Tessuto Muscolo-Scheletrico, Istituto Ortopedico G. Pini, Milano, trapianti@gpini.it) in the case of sternal resection.


Sternal reconstruction for unusual chondrosarcoma: innovative technique.

Nosotti M, Rosso L, Mendogni P, Tosi D, Palleschi A, Parafioriti A, Santambrogio L - J Cardiothorac Surg (2012)

CT images show the mass into the anterior mediastinum. On the right it is possible to observe the calcified connection between the mass and the sternum; no cortical erosion is present.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3403876&req=5

Figure 1: CT images show the mass into the anterior mediastinum. On the right it is possible to observe the calcified connection between the mass and the sternum; no cortical erosion is present.
Mentions: A 71-year-old female was referred to our Unit for anterior thoracic pain associated with a mass of the anterior mediastinum. The CT-scan detected a calcified shadow measuring 10 × 7 cm that suggested a thymoma (Figure 1). The lesion was immediately adjacent to the posterior sternal profile without any erosion of the cortex; on the contrary, one of the calcifications appeared to fusion to the left posterior sternal margin. The PET-scan was silent except for a small focal spot between the mediastinal mass and the right posterior sternal margin, corresponding approximately to the referred pain. The clinical examinations for myasthenia gravis (physical examination, antibodies against the acetylcholine receptor and single fiber electromyography) were negative. We avoided a biopsy of the lesion, considering that the tumors of the anterior mediastinum suspected for thymoma are directly referred to surgery. Keeping in mind the local fusion of the “thymoma” with the sternum and the PET spot suspected for a focal malignancy, cryopreserved allograft sternum and costal cartilage were prepared by the Regional Bank for Muscle and Bone Tissue (Banca Regionale di Tessuto Muscolo-Scheletrico, Istituto Ortopedico G. Pini, Milano, trapianti@gpini.it) in the case of sternal resection.

Bottom Line: Twelve months after surgery, the patient is in good clinical condition, without any sign of tumor relapse and with normal respiratory mechanics.Primary malignant tumors of the sternum are uncommon and a presentation mimicking thymoma is rare and unreported.The stermal replacement with a cryopreserved allograft sternum is an innovative technique that overcomes the problems related to the prosthetic biocompatibility or to the bone autograft.

View Article: PubMed Central - PubMed

Affiliation: Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, Milan, 20122, Italy.

ABSTRACT
The authors report a clinical case of a primary sternal chondrosarcoma, presented as a mass in the anterior mediastinum. The patient was treated with subtotal sternectomy and sternal transplantation followed by radiotherapy. Twelve months after surgery, the patient is in good clinical condition, without any sign of tumor relapse and with normal respiratory mechanics. Primary malignant tumors of the sternum are uncommon and a presentation mimicking thymoma is rare and unreported. The stermal replacement with a cryopreserved allograft sternum is an innovative technique that overcomes the problems related to the prosthetic biocompatibility or to the bone autograft.

Show MeSH
Related in: MedlinePlus