Eur J Cardiothorac Surg 1998;14:629-630
© 1998 Elsevier Science NL
Images in cardio-thoracic surgery |
Metastatic melanoma to the manubrium sternum
James Laredoa,
Donald J. Morrisb,
Robert L. Thurera
a Department of Surgery, Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
b Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
Received 27 July 1998;
received in revised form 17 September 1998;
accepted 30 September 1998.
Corresponding author.
A 38-year-old man previously treated for a right thigh melanoma, presented for palliative resection of a metastatic lesion to the manubrium sternum because of increasing pain.
Fig. 1
shows an MR angiogram of the chest demonstrating a 9 cm vascular tumor arising from the manubrium with involvement of the superior portion of the sternum. There was no invasion of the great vessels. Resection of the tumor required division of the sternum below the level of the third rib, with division of the first and second ribs and the heads of the clavicles lateral to the tumor. The specimen is shown in
Fig. 2
. The chest wall defect was closed with a latissimus dorsi musculocutaneous flap. Postoperatively, the patient did well and was discharged on postoperative day 4. When seen at follow-up 2 weeks later, the patient's symptoms had resolved and the chest wall flap was healing well.
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Fig. 1. MR angiogram of the chest. Sagittal view demonstrating a 9 cm vascular tumor of the manubrium sternum without involvement of the great vessels.
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Fig. 2. Photograph of the resected tumor. The remnants of the clavicles are at the superior portion of the specimen (large arrowhead). The medial remnants of the first and second ribs are present at the lateral portion of the tumor (small arrow heads). The sternum at the level of the third rib is present at the lower portion of the tumor (arrow).
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