Primary fibroblastic osteosarcoma of sternum: A case report

• Published in: Medicine (Baltimore) Vol. 101; no. 7; p. e28827
• Main Authors: Fu, Shaozi, Zhou, Yile, Xu, Heyun
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 18.02.2022
• Subjects: Bone Neoplasms - pathology; Clinical Case Report; Humans; Male; Middle Aged; Osteosarcoma - diagnostic imaging; Osteosarcoma - pathology; Osteosarcoma - surgery; Plastic Surgery Procedures - methods; Sternum - pathology; Sternum - surgery; Thoracic Neoplasms - pathology; Thoracic Neoplasms - surgery
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000028827

Osteosarcoma, a malignant bone tumor, rarely occurs in the sternum, especially the fibroblastic type, and is associated with poor survival. This case report describes a patient with a neoplasm of the sternum who underwent tumor resection 3 times and reconstruction twice because of the high risk of recurrence. A 60-year-old Chinese man presented with a 3-cm palpable bulging mass located in front of his sternum. Chest computed tomography (CT) revealed an anterior chest wall neoplasm with sternal destruction. Pathological examination revealed that the mass was a low-grade malignant primary fibroblastic osteosarcoma. Locking plates were used for chest wall reconstruction, demonstrating good structural stability and economic applicability. Regarding the ineffectiveness of current therapies, whole-exome sequencing was conducted, and no targets matched any of the currently available agents. No recurrence was found on regular reexamination. Surgery is the first choice of treatment for patients with primary fibroblastic osteosarcoma of the sternum. The reconstruction-locking plate is a good alternative for chest wall reconstruction. Whole-exome sequencing can shed new light on this uncommon disease and help identify novel therapeutic targets.