Department of CTVS, All India Institute of Medical Sciences (AIIMS), Bathinda, 151001, India.
Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India.
J Cardiothorac Surg. 2024 Mar 14;19(1):126. doi: 10.1186/s13019-024-02595-0.
Chest wall chondrosarcomas, although common, pose unique challenges due to their aggressive nature, rarity of abdominal wall involvement, and propensity for recurrence. We highlight the critical role of meticulous surgical planning, multidisciplinary collaboration, and innovative reconstruction techniques in achieving optimal outcomes for patients with composite giant chest and abdominal wall chondrosarcoma.
A 38-year-old female patient presented with progressive left chest and abdominal wall swelling for two years; on evaluation had a large lobulated lytic lesion arising from the left ninth rib, scalloping eighth and tenth ribs measuring 13.34 × 8.92 × 10.71 cm (anteroposterior/transverse/craniocaudal diameter) diagnosed with chondrosarcoma grade 2. A three-dimensional (3D) composite mesh was designed based on computed tomography using virtual surgical planning and computer-assisted design and manufacturing technology. She underwent wide local excision and reconstruction of the chest and abdominal wall with 3D-composite mesh under general anesthesia. The postoperative condition was uneventful, with no recurrence at 12 months follow-up.
A 3D-composite mesh facilitates patient-specific, durable, and cost-effective chest and abdominal wall reconstruction.
尽管胸壁软骨肉瘤较为常见,但由于其侵袭性、罕见的腹壁受累和复发倾向,仍存在独特的挑战。我们强调了精细手术规划、多学科协作以及创新重建技术在实现复合巨大胸腹壁软骨肉瘤患者最佳治疗效果方面的关键作用。
一名 38 岁女性患者因左胸和腹壁进行性肿胀两年就诊;评估时发现左第 9 肋骨处有一个大的分叶状溶骨性病变,累及第 8 和第 10 肋骨,大小为 13.34×8.92×10.71cm(前后径/横径/颅底径),诊断为 2 级软骨肉瘤。根据计算机断层扫描,使用虚拟手术规划和计算机辅助设计制造技术设计了一个三维(3D)复合网片。患者在全身麻醉下接受了广泛局部切除术和 3D 复合网片重建胸腹壁。术后情况平稳,随访 12 个月无复发。
3D 复合网片有助于实现个体化、持久且经济有效的胸腹壁重建。