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Case Reports
. 2015 Nov 28:10:178.
doi: 10.1186/s13019-015-0370-2.

Surgical management of a giant sternal chondromyxoid fibroma: a case report

Chen Chen  1 , Xiaojie Huang  2 , Mingjiu Chen  1 , Fenglei Yu  1 , Bangliang Yin  1 , Yunchang Yuan  3
Affiliations
Case Reports

Surgical management of a giant sternal chondromyxoid fibroma: a case report

Chen Chen et al. J Cardiothorac Surg. .

Abstract

Background: A primary chondromyxoid fibroma (CMF) arising from sternum is quite uncommon tumor in thoracic surgery. Removal of giant sternal tumors requires extensive resection of the anterior chest wall, and results in deformity and paradoxical movement.

Case presentation: A 40-year-old female presented a progressively enlarging mass of her anterior chest wall. Computed tomography revealed an osteolytic lesion with discrete calcification in the bone marrow of the sternum. The tumor extended across the destroyed cortex to the parietal and visceral soft aspects, involving some of the costal cartilage and most of the sternal body. Partial sternal resection was performed successfully and an individual-specific stainless steel plate was used to reconstruct the anterior chest wall. The early result was good, however, nine months after the first surgery, fractures of plate were found at bilateral plate-clavicular junction. The plate had to be removed, and a titanium mesh was used to reconstruction of the chest wall. The patient has been of disease free for more than 18 month after the second surgery.

Conclusions: Our experience indicated that the individual-specific plate may not be suitable for reconstructing both the anterior chest wall as well as the sternoclavicular joint after subtotal sternum resection.

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Figures

Fig 1
Fig 1
a, b The computed tomographic scan showed an expansive mass based on the sternal manubrium. The tumor extended across the destroyed cortex to the parietal and visceral soft aspects, involving some of the costal cartilage and most of the sternal body. c, d The size of the tumor was about 10 × 8 × 6 cm. The histological examination of the surgical specimen confirmed the diagnosis of chondromyxoid fibroma
Fig 2
Fig 2
a, b The complete resection of the tumor left a defect measuring 18 × 15 cm2 on the anterior chest wall. c An individual-specific stainless steel plate was used to reconstruct the upper sternum, the costal arch and both sternoclavicular joints. d After the individual-specific plate was removed, pleural thickening was found at the anterior chest wall defect
Fig 3
Fig 3
a X-ray showed the immediate postoperative result was favorable, since the individual-specific stainless steel plate was patient-specific, strong enough to protect the introthoracic cavity, and easy to adapt to the shape of the chest. b X-ray revealed displacement of the plate along the left 1st-3rd ribs and a fracture in the right plate-clavicular junction. c A similar plate-clavicular junction fracture developed on the left side. d Reconstruction of the chest wall was undertaken with a titanium mesh
See this image and copyright information in PMC

References

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