前胸部肋骨软骨肉瘤的罕见病例:一例报告及文献复习

A Rare Entity of the Anterior Chest Cage Rib Chondrosarcoma: A Case Report and Review of Literature.

作者信息

Al-Mourgi Majed, Shams Anwar

机构信息

Department of Surgery, College of Medicine, Taif University, Taif, Saudi Arabia.

Department of Pharmacology, College of Medicine, Taif University, Taif, Saudi Arabia; Research Center for Health Sciences, Deanship of Graduate Studies and Scientific Research, Taif University, Taif, Saudi Arabia; High Altitude Research Center, Taif University, Taif, Saudi Arabia.

出版信息

Semin Thorac Cardiovasc Surg. 2025;37(2):217-232. doi: 10.1053/j.semtcvs.2024.09.005. Epub 2024 Oct 30.

Abstract

Primary bone cancers, also called bone sarcomas, can arise anywhere in the body. Less than 1% of cancers are identified as primary bone cancers annually, and they are correlated with high rates of morbidity and death. Twenty to twenty-seven percent of primary malignant osseous neoplasms are chondrosarcomas, the rarest subtype of bone sarcomas. The incidence of chondrosarcomas in Saudi Arabia was less common than globally discovered chondrosarcomas, and only a few cases have been recorded. The most common presentation of the primary chondrosarcoma (CS) is to encompass the bony skeleton of the long bones of the lower extremities and the axial skeleton. Detecting primary CS in the anterior chest wall and the rib cage is rare. To our knowledge, chondrosarcomas of the ribs encroaching on the anterior chest are rare and have never been documented in Saudi Arabian or Middle East medical or surgical literature. We describe a case of a 32-year-old female with chondrosarcoma of the left anterior seventh rib, with no other medical or surgical histories. Further work-up at the tertiary care center, including computed tomography-scan, magnetic resonance imaging, and detailed triple bone scan (nuclear scan) imaging and histological biopsy, revealed features of chondrosarcoma arising from the ribs and involving the surrounding soft tissue. The patient underwent en masse surgical resection with a 4 cm margin, including the sixth rib and partial resection of the left hemidiaphragm and a small piece of the diaphragm. The patient was discharged without any inauspicious consequences. In the current work, we comprehensively discussed a scarce case of the anterior chest wall chondrosarcoma affecting the rib. This case highlights the importance of early detection of a rare tumor using a toolkit diagnostic approach to provide successful management and caring of the patient. Consequently, this will guarantee encouraging outcomes and thus stress the fruitful role of the surgery as the best curative modality in chondrosarcoma patients.

摘要

原发性骨癌,也称为骨肉瘤,可发生于身体的任何部位。每年确诊为原发性骨癌的病例不到癌症总数的1%,且其发病率和死亡率都很高。20%至27%的原发性恶性骨肿瘤是软骨肉瘤,这是骨肉瘤中最罕见的亚型。沙特阿拉伯软骨肉瘤的发病率低于全球发现的软骨肉瘤,仅有少数病例记录在案。原发性软骨肉瘤(CS)最常见的表现是累及下肢长骨的骨骼和中轴骨骼。在前胸壁和胸廓发现原发性CS的情况很少见。据我们所知,侵犯前胸的肋骨软骨肉瘤很罕见,沙特阿拉伯或中东地区的医学或外科文献中从未有过记载。我们描述了一例32岁女性患者,患有左前第七肋骨软骨肉瘤,无其他内科或外科病史。在三级医疗中心进行的进一步检查,包括计算机断层扫描、磁共振成像、详细的三相骨扫描(核扫描)成像和组织活检,显示为肋骨起源并累及周围软组织的软骨肉瘤特征。患者接受了整块手术切除,切缘为4厘米,包括第六肋骨、左半膈肌部分切除和一小片膈肌。患者出院时没有任何不良后果。在本研究中,我们全面讨论了一例罕见的累及肋骨的前胸壁软骨肉瘤病例。该病例强调了使用成套诊断方法早期发现罕见肿瘤对成功治疗和护理患者的重要性。因此,这将确保取得令人鼓舞的结果,并强调手术作为软骨肉瘤患者最佳治疗方式的有效作用。

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