A gigantic thorax mass – resection and reconstruction
DOI:
https://doi.org/10.48729/pjctvs.279Keywords:
Chondrosarcoma, thorax reconstruction, gigantic mass, thorax tumourAbstract
We present a rare case of a considerable chest wall mass surgically resected in a patient.
A 59-year-old woman was submitted to complete excision of a chondrosarcoma from her 4th right rib 15 years before. After that time, the patient presented with a mass on her right hemithorax, which revealed to be a recurrence after the biopsy. Chest Computed Thomography (CT) and Magnetic Ressonance Imaging (MRI) scans indicated 21x19.5x24 cm of dimen- sion, from supraclavicular fossa to upper abdomen, with the destruction of the 4th, 5th and 6th right ribs, insinuating over the
right lung, axillary vases, right hemidiaphragm and hepatic parenchyma.
The patient was submitted to a complete enbloc excision of the mass, four ribs, atypical resection of the right lower
lobe, partial resection of the right hemidiaphragm and reconstruction of the thoracic wall with polypropylene and methacry- late proteses covered with local soft tissue.
The anatomical specimen weighted approximately 11kgs.
After four days in intensive care and five days in the infirmary, the patient was discharged home; one month later she was readmitted to treat a seroma of the right hemithorax.
To date the patient is well, with no sign of recurrence.
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References
P G Casali, S Bielack, et al.: ESMO Guidelines Committee, PaedCan and ERN EURACAN, Bone sarcomas: ESMO– PaedCan–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up, Annals of Oncology, Volume 29, Issue Supplement_4, October 2018, Pages iv79–iv95.
Gladish GW, Sabloff BM, Munden RF, et al.: Primary thoracic sarcomas. RadioGraphics 2002;22(3):621–637.
F. Shahzad, K.Y. Wong, J. Maraka, M. Di Candia, et al.: Reconstruction of chest wall chondrosarcoma with an an- terolateral thigh free flap: An illustration of decision-making in chest wall reconstruction. International Journal of Surgery Case Reports (2013) Volume 4, Issue 8,Pages 669-674.
Tukiainen E. Chest wall reconstruction after oncological resections. Scand J Surg (2013) 102(1):9–13.
Khalil HH, Kalkat M, Malahias MN, et al. Chest Wall Reconstruction with Porcine Acellular Dermal Matrix (Strattice) and Autologous Tissue Transfer for High Risk Patients with Chest Wall Tumors. Plast Reconstr Surg Glob Open. 2018;6(5):e1703.
Salo, Juho T K, and Erkki J Tukiainen. “Oncologic Resection and Reconstruction of the Chest Wall: A 19-Year Experience in a Single Center.” PRS Aug. 2018
Harati K, Kolbenschlag J, Behr B, Goertz O, Hirsch T, et al.: Thoracic wall reconstruction after tumor resection. Front. Oncol.(2015) 5:247.
A. Losken, V.H. Thourani et al.: A reconstructive algorithm for plastic surgery following extensive chest wall resec- tion. The British Association of Plastic Surgeons (2004) 57, 295–302.
Sanna S, Brandolini J, et al.: Materials and techniques in chest wall reconstruction: a review. J Vis Surg 2017;3:95.
