Chen Chen, Huang Xiaojie, Chen Mingjiu, Yu Fenglei, Yin Bangliang, Yuan Yunchang
Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, #139 Renmin Middle Rd, Changsha, Hunan, 410011, P.R. China.
Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
J Cardiothorac Surg. 2015 Nov 28;10:178. doi: 10.1186/s13019-015-0370-2.
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.
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.
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.
原发性胸骨软骨黏液样纤维瘤(CMF)在胸外科中是一种相当罕见的肿瘤。巨大胸骨肿瘤的切除需要广泛切除前胸壁,会导致畸形和反常运动。
一名40岁女性,前胸壁出现一个逐渐增大的肿块。计算机断层扫描显示胸骨骨髓内有一个伴有散在钙化的溶骨性病变。肿瘤穿过破坏的皮质延伸至胸壁和内脏的软组织层面,累及部分肋软骨和大部分胸骨体。成功实施了部分胸骨切除术,并使用定制的不锈钢板重建前胸壁。早期效果良好,然而,首次手术后九个月,在双侧钢板 - 锁骨连接处发现钢板骨折。不得不取出钢板,并用钛网重建胸壁。第二次手术后患者已无病生存超过18个月。
我们的经验表明,定制钢板可能不适用于胸骨次全切除术后前胸壁及胸锁关节的重建。