Autopsy and Case Reports
Autopsy and Case Reports
Clinical Case Report

Giant chondrosarcoma of the chest wall: a rare surgical challenge

Íris M. Brito; Sérgio Teixeira; Gonçalo Paupério; Miguel Choupina; Matilde Ribeiro

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The chest wall chondrosarcoma (CWC) is a rare slowly growing primary tumor of the chest wall with an incidence of <0.5 per million person-years. We present the case of a giant CWC that caused a mass effect on the mediastinum, heart, and lung. Large tumors with thoracic structures compression may be life threatening, and its resection and subsequent chest wall reconstruction represent a significant multidisciplinary surgical challenge. In this case, despite the large tumor dimensions, the preoperative planning—sparing key reconstructive options without compromising the tumor resection—allowed a complete en bloc tumor excision of a grade III chondrosarcoma with negative histologic margins. Successful reconstruction of the large full-thickness chest wall defect, with a latissimus dorsi muscle flap and methyl methacrylate incorporated into a polypropylene mesh in a sandwich fashion, was accomplished. Patient recovery was uneventful with good functional and aesthetic outcomes, and no evidence of recurrence at 1.5 years follow-up. This case report illustrates the main clinical, radiological, and histologic features of a CWC while discussing the surgical goals and highlighting the principles for chest wall reconstruction following extensive resection of a large and rare entity.


Chondrosarcoma, Thoracic Wall, Reconstructive Surgical Procedures


Tukiainen E. Chest wall reconstruction after oncological resections.

Scand J Surg. 2013;102(1):9-13. []. [PMID:23628630]

Walsh GL, Davis BM, Swisher SG, et al. A single-institutional, multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections.

J Thorac Cardiovasc Surg. 2001;121(1):48-60. []. [PMID:11135159]

Rascoe PA, Reznik SI, Smythe WR. Chondrosarcoma of the thorax.

Sarcoma. 2011;2011:342879. []. [PMID:21647360]

Kawana S, Yamamoto H, Maki Y, Sugimoto S, Toyooka S, Miyoshi S. Reconstruction of anterior chest wall with polypropylene mesh: two primary sternal chondrosarcoma cases.

Acta Med Okayama. 2017;71(3):259-62. []. [PMID:28655947]

Abraham VJ, Devgarha S, Mathur RM, Sisodia A, Yadav A. Dedifferentiated chondrosarcoma of the rib masquerading as a giant chest wall tumor in a teenage girl: an unusual presentation.

Korean J Thorac Cardiovasc Surg. 2014;47(4):427-30. []. [PMID:25207259]

Sangma MM, Dasiah S. Chondrosarcoma of a rib.

Int J Surg Case Rep. 2015;10:126-8. []. [PMID:25841154]

Arnold PG, Pairolero PC. Chest-wall reconstruction: an account of 500 consecutive patients.

Plast Reconstr Surg. 1996;98(5):804-10. []. [PMID:8823018]

Althubaiti G, Butler CE. Abdominal wall and chest wall reconstruction.

Plast Reconstr Surg. 2014;133(5):688e-701e. []. [PMID:24776572]

Chang RR, Mehrara BJ, Hu QY, Disa JJ, Cordeiro PG. Reconstruction of complex oncologic chest wall defects: a 10-year experience.

Ann Plast Surg. 2004;52(5):471-9, discussion 479. []. [PMID:15096930]

Mansour KA, Thourani VH, Losken A, et al. Chest wall resections and reconstruction: a 25-year experience.

Ann Thorac Surg. 2002;73(6):1720-5, discussion 1725-6. []. [PMID:12078759]

Losken A, Thourani VH, Carlson GW, et al. A reconstructive algorithm for plastic surgery following extensive chest wall resection.

Br J Plast Surg. 2004;57(4):295-302. []. [PMID:15145731]

Hameed A, Akhtar S, Naqvi A, et al. Reconstruction of complex chest wall defects by using polypropylene mesh and a pedicled latissimus dorsi flap: a 6-year experience.

J Plast Reconstr Aesthet Surg. 2008;61(6):628-35. [].

Kachroo P, Pak PS, Sandha HS, et al. Single-institution, multidisciplinary experience with surgical resection of primary chest wall sarcomas.

J Thorac Oncol. 2012;7(3):552-8. []. [PMID:22307013]

Netscher DT, Baumholtz MA. Chest reconstruction: I. Anterior and anterolateral chest wall and wounds affecting respiratory function.

Plast Reconstr Surg. 2009;124(5):240e-52e. []. [PMID:20009799]

Khullar OV, Fernandez FG. Prosthetic reconstruction of the chest wall.

Thorac Surg Clin. 2017;27(2):201-8. []. [PMID:28363375]

Ng CS. Recent and future developments in chest wall reconstruction.

Semin Thorac Cardiovasc Surg. 2015;27(2):234-9. []. [PMID:26686454]

Billè A, Okiror L, Karenovics W, Routledge T. Experience with titanium devices for rib fixation and coverage of chest wall defects.

Interact Cardiovasc Thorac Surg. 2012;15(4):588-95. []. [PMID:22815325]

De Palma A, Sollitto F, Loizzi D, et al. Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system.

J Thorac Dis. 2016;8(3):490-8. []. [PMID:27076945]

Salo JTK, Tukiainen EJ. Oncologic resection and reconstruction of the chest wall: a 19-year experience in a single center.

Plast Reconstr Surg. 2018;142(2):536-47. []. [PMID:29889739]


























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