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酷似乳腺癌的肋骨软骨肉瘤:病例报告及文献复习

Costal chondrosarcoma mimicking a breast cancer: Case report and review of literature.

作者信息

Tounsi Nesrine, Zemni Ines, Abdelwahed Nawel, Jbir Ichraf, Charfi Lamia, Ben Nasser Radhi, Chargui Riadhe, Rahel Khaled

机构信息

Department of Surgical Oncologists, Salah-Azaiez Institute, Boulevard of 9-Avril, 1001 Tunis, Tunisia.

Department of Surgical Oncologists, Salah-Azaiez Institute, Boulevard of 9-Avril, 1001 Tunis, Tunisia.

出版信息

Int J Surg Case Rep. 2019;56:37-39. doi: 10.1016/j.ijscr.2019.02.009. Epub 2019 Feb 14.

Abstract

INTRODUCTION

Chondrosarcoma (CS) was the third most common primary bone malignancy. Frequently chondrosarcoma was occurring in long bones or in the pelvis. Their localization in the rib is rare.

CASE PRESENTATION

A 45-year-old male presented to our institution with a lump in the left breast. A physical exam revealed a large, fixed 10 cm mass occupied the entire right breast. Clinical presentation had supposed initially as a sarcoma of the breast. Preoperative unenhanced CT imaging showed well-defined round heterogeneous soft tissue density with hypo dense areas. A core-needle biopsy was taken, which was suggestive of chondrosarcoma grade II. The whole tumor was excised en-bloc along with 4th, 5th and 6th ribs. Reconstruction of the defect was undertaken with polypropylene plate and ipsilateral pedicle latissimus dorsi muscle flap was placed on the alloplastic mesh. The patient had an uneventful postoperative course and was discharged on the 10th postoperative day. No adjuvant treatment was administrated.

CONCLUSION

En-bloc resection with appropriate margins and thanks to the evolution of reconstructive surgical techniques used to ensure preservation of respiratory mechanics. All this procedure represents the cornerstone and the only curative option.

摘要

引言

软骨肉瘤(CS)是第三常见的原发性骨恶性肿瘤。软骨肉瘤常发生于长骨或骨盆。其在肋骨的定位罕见。

病例介绍

一名45岁男性因左乳肿块就诊于我院。体格检查发现一个10厘米大的固定肿块占据了整个右乳。临床表现最初推测为乳腺肉瘤。术前未增强CT成像显示边界清晰的圆形不均匀软组织密度,伴有低密度区。进行了粗针活检,提示为二级软骨肉瘤。整个肿瘤连同第4、5和6肋骨整块切除。用聚丙烯板修复缺损,并将同侧带蒂背阔肌肌瓣置于异体网状物上。患者术后恢复顺利,术后第10天出院。未进行辅助治疗。

结论

进行适当切缘的整块切除,并得益于用于确保呼吸力学保留的重建手术技术的发展。所有这些操作是基石和唯一的治愈选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0621/6393690/13e7e7f137f7/gr1.jpg

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