Resection of a giant sternal chondrosarcoma and chest wall reconstruction: a case report

Chondrosarcomas are common bone carcinomas; however, they are uncommon in the sternum, and giant sternal tumors have rarely been reported in advanced-age patients. This study aimed to describe the clinical presentation, method of preoperative planning and surgery, and perioperative management of a giant sternal chondrosarcoma in an advanced-age patient. We describe the case of an 80-year-old woman who presented with a rare giant sternal chondrosarcoma. The patient's symptoms included significant painful swelling and limited activity. The mass was firm and fixed, and the boundary was unclear. We first performed a simulated surgery on a three-dimensional (3D) model using the mimics system for preoperative planning. An extensive resection of the tumor was then performed. Due to the financial status of the patient, the huge chest wall defect was reconstructed with simple ordinary metal locking bone plates and polyester surgical mesh, and good results were achieved. The patient was discharged without any complications 12 days after surgery. The postoperative pathological examination confirmed the diagnosis of primary grade I-II chondrosarcoma. At the 12-month follow-up examination, the patient was completely rehabilitated, and there was no evidence of recurrence. Giant, low-grade sternal chondrosarcoma is an extremely rare disease in elderly women. 3D modeling and simulated surgery are effective approaches for the preoperative planning of surgery. Postoperative ventilators, antibiotics, and nutritional support are also necessary. Using our reconstructive techniques, chest wall reconstruction with polyester patches and orthopedic steel plates could be a safe, reliable and affordable surgery procedure. It may be an appropriate option for similar cases.