Eur J Cardiothorac Surg 2004;25:1124-1125
© 2004 Elsevier Science NL
Images in cardio-thoracic surgery |
Massive primary chest wall chondrosarcoma
Eric L.R. Bédard,
Augustine Tang,
Michael R. Johnston*
Toronto General Hospital, Division of Thoracic Surgery, Suite 10 EN-2230, 200 Elizabeth Street, Toronto, Ont., Canada M5G 2C4
Received 11 December 2003;
received in revised form 18 February 2004;
accepted 20 February 2004.
* Corresponding author. Tel.: +1-416-340-3838; fax: +1-416-340-3660
e-mail: michael.johnston{at}uhn.on.ca
Key Words: Rib • Chondrosarcoma • Surgery
A 37-year-old woman presented with a 22 cm by 16 cm chest wall sarcoma. No significant response to induction cisplatin and doxorubicin was seen. Radical en-bloc excision of the mass with portions of chest wall, diaphragm, pericardium and lung was performed. The chest wall was reconstructed with Marlex mesh and TRAM flap. Histopathology showed de-differentiated rib chondrosarcoma (grade II/III). Recovery was uneventful and at 9 months post-op the patient was alive, with evidence of pulmonary metastases being considered for resection (Figs. 1 and 2)
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Fig. 1. Cardiac MRI with axial (a) and coronal (b) FIESTA images demonstrating the large mass (asterisk) compressing the heart and liver (L); displacing the IVC (arrow) and aorta (arrowhead); and invading the diaphragm.
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Fig. 2. Intra-operative photograph showing en bloc resection of the giant chest wall chondrosarcoma. S, overlying skin; R, attached ribs; P, pericardium; Lu, right lower lobe of lung; Li, liver; RA, right atrium.
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