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Del Grande F, Ahlawat S, McCarthy E, Fayad LM. Grade 1 and 2 Chondrosarcomas of the Chest Wall: CT Imaging Features and Review of the Literature. Diagnostics (Basel) 2022; 12:diagnostics12020292. [PMID: 35204383 PMCID: PMC8870800 DOI: 10.3390/diagnostics12020292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 01/21/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Filippo Del Grande
- The Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD 21205, USA; (S.A.); (L.M.F.)
- Clinica di Radiologia EOC, Via Tesserete, 6900 Lugano, Switzerland
- Correspondence: ; Tel.: +41-91-811-60-69; Fax: +41-91-811-60-90
| | - Shivani Ahlawat
- The Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD 21205, USA; (S.A.); (L.M.F.)
| | - Edward McCarthy
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Laura M. Fayad
- The Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD 21205, USA; (S.A.); (L.M.F.)
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Abstract
Background. Chondrosarcomas represent approximately 30% of primary malignant bone tumors, the most frequent of which is on anterior thoracic wall. Case report. We presented a case of 50-year-old man suffering from a slowgrowing, painless giant chondrosarcoma of the anterior chest wall. A wide resection was performed to excise the tumor including attached skin, right breast, ribs, sternum, soft tissues and parietal pleura. Mediastinum was not affected by the tumor. After resecting a 26 ? 20 ? 22 cm segment, the chest wall defect was reconstructed with a Marlex mesh and extensive latissimus dorsi myocutaneous flap pedicled on the right thoracodorsal vessels. Histopatology diagnosis was chondrosarcoma G 2?3. The mechanics of ventilation was not altered and respiratory function was normal from the immediate postoperative period. Three years after the operation postoperative results showed no local recurrence and excellent functional and aesthetic results were evident. Respiratory function remained unaltered. Conclusion. According to the results it can be concluded that the use of Marlex mash and myocutaneous flap is good method for stabilization of the chest wall and enough to avoid paradoxical respiratory movements in managing giant chondrosarcoma of the anterior chest wall.
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