Pediatric Chondrosarcoma of the Sternum Resected with Thorascopic Assistance



Harpreet S. Bawa1, *, Drew D. Moore2, Juan C. Pelayo3, Nicole Cipriani4, Grace Mak5, Rex C. Haydon1
1 Department of Orthopaedic Surgery and Rehabilitation Medicine University of Chicago Division of Biological Sciences 5841 South Maryland Avenue MC 3079 Chicago, IL 60637, USA
2 Department of Orthopaedic Surgery William Beaumont Hospital 3535 West 13 Mile Road, Suite 704 Royal Oak, MI 48073, USA
3 Children's Hospital Los Angeles Division of Pediatric Surgery 4650 Sunset Blvd., #100 Los Angeles, CA 90027, USA
4 Department of Pathology University of Chicago Division of Biological Sciences 5841 South Maryland Avenue MC 4062 Chicago, IL 60637, USA
5 Department of Pediatric Surgery University of Chicago Division of Biological Sciences 5841 South Maryland Avenue MC 4062 Chicago, IL 60637, USA


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© 2017 Bawa et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Orthopaedic Surgery and Rehabilitation Medicine University of Chicago Division of Biological Sciences 5841 South Maryland Avenue MC 3079 Chicago, IL 60637, USA; Tel: 773-834-1634; Fax: 773-702-4384; E-mail: hbawa@uchicago.edu


Abstract

Background:

Chondrosarcomas are a heterogeneous group of malignant neoplasms that arise from bones, cartilage or other soft tissues that produce cartilage and are commonly seen in the middle decades of life. Despite being the most common primary bone sarcoma in adults, chondrosacromas are rare in pediatric patients.

Case Report:

We report the case of a six-year-old child with a painless enlarging sternal mass of which biopsy was consistent with low-grade surface chondrosarcoma. This is the first reported case of a chest wall chondrosarcoma in a young child. This unusual location in a young patient presented challenges to treatment. Resection of the manubrium was performed by a multidisciplinary team of orthopaedic oncology and pediatric general surgery. The patient underwent a wide resection of the sternal mass from an anterior approach performed by the orthopaedic oncology team using an oscillating saw under video-assisted thoracoscopic surgery to ensure adequate mass resection without injury to nearby structures. The patient was followed with quarterly physical exams and radiographs for 18 months postoperatively and did not have any pain or evidence of recurrence.

Conclusion:

Clinicians should consider utilizing multidisciplinary approaches to treat patients with chondrosarcomas of the chest wall.

Keywords: Chondrosarcoma, Chest wall mass, Video-assisted thoracoscopic surgery, Sternal tumor, Sarcoma.