Radical resection of a giant rib osteosarcoma with complex chest wall reconstruction

摘要

Introduction Primary rib osteosarcoma is a rare chest wall tumor with variable presentation. Large tumors greater than 10?cm are even rarer and present a challenge for surgical management. Presentation of case A 61-year-old male with a giant osteosarcoma of the left 2supnd/sup rib underwent multidisciplinary management including induction therapy with doxorubicin and cisplatin, followed by en bloc resection with left ribs 1–5, spinous processes of ribs 2–5, small volume lung resection, and chest wall reconstruction with polypropylene mesh and poly methyl methacrylate (PMMA or bone cement). There were no perioperative complications. At 6 months follow-up, the patient remains disease-free. Functional and cosmetic outcome are excellent. Discussion This 20?cm mass and resection of ribs 1–5 with resulting 25?cm chest wall defect is the largest primary rib osteosarcoma reported in literature. An R0 resection and chest wall reconstruction using polypropylene mesh and bone cement was feasible and safe. Conclusion Giant chest wall defects involving multi-rib resection can be effectively reconstructed with commonly available and inexpensive polypropylene mesh and PMMA to achieve good cosmetic and functional outcomes.