Stable construction of the sternum after broad radical resection of malignant tumours
A 60-year-old male patient presented himself to the outpatient clinic of our department with a progressive sternal mass. An MRI scan indicated a tumour involving the manubrium extending to the first and second ribs and involving the right clavicle and sternoclavicular joint (Figs and ). Based on radiological evaluation, a core biopsy was obtained and a low-grade chondrosarcoma was characterized. Radiological evaluation indicated primary tumour resection to be the treatment of choice. Radical excision of the tumour was performed and resulted in resection of the manubrium, as well as the medial third of the right clavicle and the right first and second ribs. Steel wires through the sternum and left sternoclavicular joint spanned the 6.5 cm sternal defect (Figs and ) and a polypropylene mesh filled with methyl methacrylate composite (Surgical Simplex®), Howmedica Osteonics, Limerick, Ireland, was placed, yielding a stable reconstruction of the sternal defect (Figs –). The sternocleidomatoideus muscle was re-inserted to the polypropylene mesh. Pathological examination showed complete excision of the tumour. The patient recovered uneventfully and was discharged 7 days post-operatively. At seven year follow-up, the patient displayed excellent functional and aesthetic results. Optimal function of his shoulders allowed a complete return to work and other activities without disabilities.