胸骨腫瘍切除後のポリプロピレンメッシュによる胸壁再建術

Chest Wall Reconstruction with Polypropylene Mesh After Resection of Primary Sternal Chondrosarcoma

胸骨腫瘍は全骨腫瘍の0.94％とまれな疾患である1）．われわれ胸骨原発軟骨肉腫に対し，胸骨部分切除とポリプロピレンメッシュによる胸骨再建を行った1例を経験したので報告する．

Although rare, primary sternal chondrosarcoma （PSC） is the most common primary malignant chest wall tumor. Here, we report a rare case of PSC treated with partial sternal resection and reconstruction. A 47-year-old man presented with subcutaneous anterior chest wall mass and chest pain. Chest computed tomography （CT） at the previous hospital revealed a 4.5 cm chest wall tumor involving the sternum at the fourth to fifth ribs and surrounding soft tissues. Percutaneous needle biopsy was performed, and grade 1 PSC was suspected. The patient was referred to our hospital for surgical treatment. A skin incision was made to include the subcutaneous needle biopsy site. Tumor margin ＞3.0 cm was guaranteed, and partial sternal resection was performed with resection from bilateral third costal cartilages to the xiphoid process. Since two-thirds of the sternum was removed and the defect was wide, the chest wall was reconstructed using two layers of 15×15 cm polypropylene mesh. The postoperative course was uneventful and the patient did not show flail chest. He was discharged on postoperative day 5 and had no tumor recurrence for 2 years.