Novel Chest Wall Reconstruction Following Excision of an Xiphisternal Chondrosarcoma

• Published in: The Ochsner journal Vol. 18; no. 2; pp. 180 - 182
• Main Authors: Hann, Miranda C, Pettiford, Brian, Babycos, Christopher
• Format: Journal Article
• Language: English
• Published: United States Ochsner Clinic Foundation Academic Center - Publishing Services 01.01.2018; Academic Division of Ochsner Clinic Foundation
• Subjects: Case reports; Case Reports and Clinical Observations; Defects; Medical imaging; Patients; Skin & tissue grafts; Titanium; Tumors; Chondrosarcoma; polypropylene; omentum; surgical flaps
• ISSN: 1524-5012; 1524-5012
• DOI: 10.31486/toj.17.0066

Chondrosarcoma, the most common primary malignant tumor of the chest wall, most frequently arises from the sternum, with limited reported cases of tumor origination from the xiphoid process. Because of the location, patients present with complaints of a large chest wall mass associated with pain and respiratory symptoms. These tumors are best managed by en bloc resection and chest wall reconstruction. A 49-year-old male nonsmoker with a strong family history of colon cancer presented with a large, painful chest wall mass associated with shortness of breath and exertional chest pressure. Computed tomography scan demonstrated a large mass arising from the xiphoid process; biopsy confirmed a grade 1 chondrosarcoma. The mass was removed en bloc and repaired with an innovative technique using omentum and PROCEED Surgical Mesh (Ethicon US, LLC). The wound was closed with a fasciocutaneous flap. To our knowledge, this case is the first report of a chest wall reconstruction of a large inferior sternal defect using only polypropylene and omentum without a rigid support or muscular flap. This repair option could be considered for patients in whom traditional rigid repair methods have potential complications or limitations.