rozpoznanie ustalono na podstawie obrazu tomografii komputerowej klatki piersiowej , biopsji chirurgicznej lub wycicia guza . rekonstrukcje mostka wykonywano siatk alogeniczn ( polipropylen ) i okolicznymi tkankami ( najczciej misie piersiowy wikszy ) . po 2 latach odnotowano 4 przypadki nawrotu chrzstniakomisaka ( wznowa miejscowa w 1 przypadku i przerzuty do puc w 3 przypadkach ) . leczenie guzw mostka zaley od ich typu histologicznego i moliwoci chirurgicznego wycicia . rekonstrukcje ciany klatki piersiowej wykonuje si za pomoc materiaw autogennych lub alogennych . management depends mainly on their histological type , local aggressiveness and the possibility of chest wall reconstruction . we report on a series of 30 cases of sternal tumours treated in our institution between 2006 and 2015 . there were 16 men , 14 women , average 54.4 years ( range : 2673 ) . most patients had the following symptoms : pain ( 22 cases ) , a palpable mass ( all patients ) and swelling ( 6 cases ) in the sternoclavicular joint region . tumours were located in the sternoclavicular joint in 6 cases , in the manubrium in 7 , in the body in 14 and in the xyphoid process in 2 cases . one patient had a large infiltration of the chest wall , and it was difficult to establish the location of the disease . the histological type of tumour was determined by surgical biopsy or excision of the tumour . histological types of sternal tumours the size of the tumour was determined by a chest computed tomography ( ct ) scan ( figs . 1 and 2 ) . the size of the benign lesions was 1.8 cm to 4.9 cm and of the malignant lesions was 3.6 cm to 10.2 cm . all malignant tumours were located in the body of the sternum , metastatic in the manubrium , inflammatory in the sternoclavicular joints , and benign in different parts of the sternum . b  view of the sternum before the operation before surgery , pulmonary function tests were routinely used in all patients , and a metastatic work - up was undertaken to eliminate an extrathoracic metastatic lesion . surgical excision of the tumour was undertaken in 24 cases , surgical biopsy in 6 . following general anaesthesia the sternal tumours located in the chest wall with at least a 4 cm margin were totally removed . for small resection direct closure was performed . for the longer defects , a prosthesis was sutured with 0-prolene sutures to the edges of the resected chest wall . after whole body sternal resection , polypropylene / methyl methacrylate sandwiched mesh was used for closing the defect . in 1 case microscopic evaluation of the margins by frozen section was not routinely performed due to wide resection . the first visit was in the 4 weeks postoperatively , and then patients were seen every 3 months in the first year , every 6 months in the second and subsequently every 12 months . local recurrence was observed after 2 years in 2 patients and lung metastases in 2 patients with chondrosarcoma . chondrosarcoma is the most common tumour of the sternum , followed by osteosarcoma , myeloma and malignant lymphoma . benign sternal tumours according to the mayo clinic were found in 0.1% of all benign bone tumours . among benign chondromas , osteoblastoma and haemangioma two thirds of sternal tumours are metastatic or locally invasive . most frequently , there is breast cancer invasion , lung or pleural malignancy invasion or rarely solitary metastasis from the kidney or thyroid [ 7 , 8 ] . clinical signs are not specific . chest pain , palpable mass and signs of swelling are frequently found . a ct scan of the chest gives precise information about extension , pulmonary invasion or metastases and aids in the assessment of mediastinal lymph nodes . the diagnosis was obtained by surgical biopsy . however , even surgical biopsies may be uncertain when the cortex of the sternum is not involved . for this reason most of our patients had surgical excision of the tumour ( 24 cases ) . the causes of sternoclavicular joint pain and swelling were usually non - malignant , and moderate to severe degenerative changes were found . in the manubrium we found 2 metastases ( 1 from a kidney , 1 from a thyroid ) . distant solitary metastases of kidney or thyroid cancer to the sternum are very rare and associated with a poor prognosis [ 7 , 8 ] . tumours in the xyphoid process were non - malignant and very easy to remove . whenever possible , surgery is the best therapeutic option for a sternal tumour . in some cases radiation and/or chemotherapy may be used pre- or postoperatively , especially in tumours with sensitivity to their treatment ( hodgkin or non - hodgkin lymphoma , plasmocytoma ) . the resection margin has been discussed in the literature since the extent of resection is associated with radical resection . most suggest a 45 margin , or simply negativity in a frozen section without a specific distance was safe enough . many techniques have been described for the closure of the chest wall defect to minimize paradoxical movement and protect the mediastinal structures after sternal resection [ 1114 ] . autoplastic reconstruction is suggested for small defects , while alloplastic materials are suggested for larger defects . reconstruction with a skin flap , myocutaneous flaps , marlex mesh , gore - tex dual mesh , methyl methacrylate sandwiched between marlex mesh , allogenic sternal graft , autogenous rib graft , porous titanium mesh , and metallic bars was described [ 5 , 1114 ] . in our patients we used polypropylene mesh , and we obtained rigidity ( when necessary ) by using a methyl methacrylate sandwich . after manubrium resection , a muscle flap is recommended and rigid reconstruction after lower sternal resection to protect the heart and stabilise the thorax . the role of chemotherapy and/or radiation in sternal tumours remained unclear . for tumours that appeared to be radio / chemosensitive ( hodgkin lymphoma , ewing sarcoma , plasmocytoma ) and patients who were at high risk of local recurrence or compromised margin a benefit from adjuvant treatment might be obtained . despite the adjuvant treatment our 4 patients with chondrosarcoma had local or metastatic recurrence .