Bawa Harpreet S, Moore Drew D, Pelayo Juan C, Cipriani Nicole, Mak Grace, Haydon Rex C
Department of Orthopaedic Surgery and Rehabilitation Medicine University of Chicago Division of Biological Sciences 5841 South Maryland Avenue MC 3079 Chicago, IL 60637, USA.
Department of Orthopaedic Surgery William Beaumont Hospital 3535 West 13 Mile Road, Suite 704 Royal Oak, MI 48073, USA.
Open Orthop J. 2017 May 31;11:479-485. doi: 10.2174/1874325001711010479. eCollection 2017.
Chondrosarcomas are a heterogeneous group of malignant neoplasms that arise from bones, cartilage or other soft tissues that produce cartilage and are commonly seen in the middle decades of life. Despite being the most common primary bone sarcoma in adults, chondrosacromas are rare in pediatric patients.
We report the case of a six-year-old child with a painless enlarging sternal mass of which biopsy was consistent with low-grade surface chondrosarcoma. This is the first reported case of a chest wall chondrosarcoma in a young child. This unusual location in a young patient presented challenges to treatment. Resection of the manubrium was performed by a multidisciplinary team of orthopaedic oncology and pediatric general surgery. The patient underwent a wide resection of the sternal mass from an anterior approach performed by the orthopaedic oncology team using an oscillating saw under video-assisted thoracoscopic surgery to ensure adequate mass resection without injury to nearby structures. The patient was followed with quarterly physical exams and radiographs for 18 months postoperatively and did not have any pain or evidence of recurrence.
Clinicians should consider utilizing multidisciplinary approaches to treat patients with chondrosarcomas of the chest wall.
软骨肉瘤是一组异质性恶性肿瘤,起源于骨骼、软骨或其他产生软骨的软组织,常见于中年。尽管软骨肉瘤是成人中最常见的原发性骨肉瘤,但在儿科患者中却很少见。
我们报告了一例6岁儿童,其胸骨肿物无痛性增大,活检结果与低级别表面软骨肉瘤相符。这是首次报道的幼儿胸壁软骨肉瘤病例。该肿物在年轻患者中的这个不寻常位置给治疗带来了挑战。由骨科肿瘤学和小儿普通外科的多学科团队进行了胸骨柄切除术。患者接受了骨科肿瘤学团队从前路进行的胸骨肿物广泛切除术,在电视辅助胸腔镜手术下使用摆动锯,以确保充分切除肿物而不损伤附近结构。术后对患者进行了为期18个月的每季度一次体格检查和X光检查,患者没有任何疼痛或复发迹象。
临床医生应考虑采用多学科方法治疗胸壁软骨肉瘤患者。