Di Fabio D, Milano S, Benvenuti M, Benetti D, Mombelloni G
Divisione Chirurgia Cardio, Toracica, Spedali Civili, Brescia.
Minerva Chir. 1996 May;51(5):359-63.
The authors report on a rare case of pulsating tumor of the sternum. En bloc resection was carried out with removal of the sternal manubrium and body, tracts of the I-II-III rib with the intercostal muscles and part of the left pectoralis major. Reconstruction of the thoracic wall was performed with a marlex MMA sandwich prosthesis. From a histological viewpoint, the carcinoma was well differentiated and compatible with thyroid primitivity. Non complementary antiblastic therapies were provided as all the examinations carried out were negative and the intervention was radical. The patient had been followed-up with serial controls and three complete stagings at one, three and five years after intervention (CT, echography and function tests of the thyroid, bone scintigraphy). At follow-up of more than six years the patient is doing well and is event free. The authors believe, even with the help of reports from the literature that, in sternal metastases from thyroid carcinomas, especially when single and large, surgical therapy is required.
作者报告了一例罕见的胸骨搏动性肿瘤病例。进行了整块切除，切除了胸骨柄和胸骨体、第I-II-III肋骨及其肋间肌以及部分左胸大肌。采用Marlex MMA三明治假体进行胸壁重建。从组织学角度来看，该癌分化良好，与甲状腺原基相符。由于所有检查均为阴性且手术为根治性，因此未提供辅助抗增殖治疗。对患者进行了连续监测，并在干预后1年、3年和5年进行了三次完整的分期检查（CT、超声检查以及甲状腺功能测试、骨闪烁显像）。在随访超过六年时，患者情况良好，无复发。作者认为，即使参考文献报道，对于甲状腺癌的胸骨转移，尤其是单发且肿瘤较大时，仍需要进行手术治疗。
