Chondrosarcoma of a rib

Grade 1 and 2 Chondrosarcomas of the Chest Wall: CT Imaging Features and Review of the Literature

The purpose of our retrospective article is to review the CT imaging features of chondrosarcomas of the chest wall with pathologic correlation. For 26 subjects with biopsy-proven chondrosarcomas of the chest wall, two musculoskeletal radiologists retrospectively reviewed 26 CT scans in consensus. Descriptive statistics were performed. The mean tumor size was 57 mm. Twenty (20/26, 77%) chondrosarcomas were located in the ribs and six (6/26, 23%) in the sternum. The majority were lytic (19/26, 73%) with <25% calcification (15/26, 58%), and with a soft tissue mass (22/27, 85%). In this study CT features of grade 1 chondrosarcoma overlapped with those of grade 2 tumors. In conclusion, chondrosarcomas of the chest wall are generally lytic with an associated soft tissue mass, showing little calcified matrix and low-to-intermediate grade.

Chondrosarcoma of the rib: Atypical presentation and management

Chondrosarcoma is an uncommon malignant tumor of the rib and can have an atypical presentation based on age, gender, and clinical manifestation with differential diagnosis of intrathoracic mass. Management is surgical as the tumor is resistant to chemoradiation. Access to chest wall reconstruction is limited in many low-income countries and forms a barrier to patient compliance. We report an atypical presentation and describe a simple, easy, and cost-effective chest wall reconstruction method for chondrosarcoma of the rib in any resource-constrained setting.

Giant chondrosarcoma of the chest wall: a rare surgical challenge

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.

Prognosis and treatment differences between initial and second primary chondrosarcoma

Prognosis and treatment differences between initial and second primary chondrosarcoma (pCS) remain unknown. In the present study, patients with chondrosarcoma diagnosed between January 2004 and December 2015 were identified using the Surveillance Epidemiology and End Results database. Kaplan-Meier curves and log-rank tests were used to assess overall survival (OS) and cancer-specific survival. Univariable and multivariable Cox regression analyses were used to determine factors associated with all-cause mortality and cancer-specific mortality. In total, 1,655 eligible patients were included in the cohort of the present study, of which, 1,455 (87.9%) had initial pCS and 200 (12.1%) had second pCS. Patients with second pCS were more frequently diagnosed in the age range of 61–80 years compared with patients with initial pCS (52.5 vs. 43.1%; P<0.001). The OS rate of patients with initial pCS was significantly higher than that of patients with second pCS (78.3 vs. 63.0%; P<0.001). Multivariable logistic regression analyses suggested that second pCS predicted higher all-cause mortality (hazard ratio, 1.72; 95% confidence interval, 1.31–2.26, P<0.001) compared with that in patients with initial pCS. Furthermore, there were no differences observed in the treatment benefits between the patients with initial and second pCS. In conclusion, second pCS was more frequently diagnosed in older patients compared with initial pCS. In addition, the prognosis of patients with second pCS was worse than that of patients with initial pCS, and the treatment is essentially the same for initial and second pCS.

Costal chondrosarcoma mimicking a breast cancer: Case report and review of literature

•

The localization of chondrosarcoma in the rib is rare.

•

Prognostic of chondrosarcoma is relatively good.

•

Generally, chondrosarcoma is radio- resistant and chemo-resistant.

•

The cornerstone and the only curative option for CS was en-bloc resection with appropriate margins.

Introduction

Chondrosarcoma (CS) was the third most common primary bone malignancy. Frequently chondrosarcoma was occurring in long bones or in the pelvis. Their localization in the rib is rare.

Case presentation

A 45-year-old male presented to our institution with a lump in the left breast. A physical exam revealed a large, fixed 10 cm mass occupied the entire right breast. Clinical presentation had supposed initially as a sarcoma of the breast. Preoperative unenhanced CT imaging showed well-defined round heterogeneous soft tissue density with hypo dense areas.

A core-needle biopsy was taken, which was suggestive of chondrosarcoma grade II. The whole tumor was excised en-bloc along with 4th, 5th and 6th ribs. Reconstruction of the defect was undertaken with polypropylene plate and ipsilateral pedicle latissimus dorsi muscle flap was placed on the alloplastic mesh. The patient had an uneventful postoperative course and was discharged on the 10th postoperative day. No adjuvant treatment was administrated.

Conclusion

En-bloc resection with appropriate margins and thanks to the evolution of reconstructive surgical techniques used to ensure preservation of respiratory mechanics. All this procedure represents the cornerstone and the only curative option.