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OBJECTIVE: To study the sternum ossification processes that take place over time as well as the possibilities of sternum X-rays application to evaluate the age on the modern Russian population in forensic terms. MATERIAL AND METHODS: Sternum X-rays with fragments of ribs' chondral parts were obtained from 369 male and female corpses aged 12-96 years without pathological and traumatic changes. The X-rays were done in frontal projection. The set of examined parameters included: complete and partial synostosis of manubrium and body, induration along the synostosis (or on the articulated edges of manubrium and body), complete and partial synostosis of body segments, traces of body segments union, complete and partial synostosis of body and xiphoid process, induration along the synostosis (or on the articulated edges of manubrium and body), form of costal notches, induration of articular edges of body, presence of calcification foci in sternal edge of II-VII ribs' cartilages, depth of sternum notches, overgrowths on articular edges of body, presence of union between body's costal notches and calcification centers of ribs' cartilages. Mean values, standard deviation and correlation coefficient were determined. RESULTS: The maximal correlation with age was found in such parameters such: overgrowths on articular edges of body (r=0.6), presence of calcification foci in sternal edge of II-VII ribs (r=0.6), induration of body's articular edges (r=0.5), presence of union between costal notches and calcification centers of ribs cartilages (r=0.5), synostosis of body and xiphoid process (r=0.4). CONCLUSION: A subsequent construction of linear model for age diagnosis has its details when comparing the predicted age with the real.
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Determinación de la Edad por el Esqueleto , Antropología Forense , Osteogénesis , Esternón , Humanos , Esternón/patología , Esternón/diagnóstico por imagen , Determinación de la Edad por el Esqueleto/métodos , Masculino , Antropología Forense/métodos , Osteogénesis/fisiología , Femenino , Adulto , Persona de Mediana Edad , Anciano , Adolescente , Federación de Rusia , Niño , Anciano de 80 o más Años , Adulto JovenRESUMEN
OBJECTIVE: To analyze bone tissue damage at different stages of disease (El Oakley classification), treatment options for each clinical situation and results after each approach. MATERIAL AND METHODS: There were 45 patients with wound complications after cardiac surgery between October 2022 and September 2023. Thirty-eight (84.4%) patients underwent CABG, 7 (15.6%) patients - heart valve or aortic surgery. Mean age of patients was 68.1±10.3 years. There were 35 men (77.8%) and 10 women (22.2%). The first type was found in 11 (24.5%) patients, type 2-3 - 19 (42.2%), type 4 - 4 (8.8%), type 5 - 11 (24.5%) patients. RESULTS: Systemic inflammatory response syndrome was observed in 7 (36.8%) persons of the 1st group, 14 (73.7%) ones of the 2nd group, 4 (100%) patients of the 3rd group and 2 (18.2%) patients of the 4th group. C-reactive protein and procalcitonin increased in all patients with the highest values in groups 2 and 3. Redo soft tissue inflammation occurred in all groups after treatment. Mean incidence was 25%. Two (10.5%) patients died in the 2nd group and 1 (25%) patient in the 3rd group. CONCLUSION: The modern classification of sternomediastinitis does not fully characterize severity of disease in a particular patient. Simultaneous debridement with wound closure demonstrates acceptable mortality (within 10%). The highest mortality rate was observed in patients with diffuse lesions of the sternum. Less aggressive treatment approaches are possible for stable anterior chest wall.
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Mediastinitis , Complicaciones Posoperatorias , Humanos , Masculino , Femenino , Mediastinitis/etiología , Mediastinitis/diagnóstico , Mediastinitis/terapia , Anciano , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Procedimientos Quirúrgicos Cardíacos/métodos , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Esternón/cirugía , Esternón/patología , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Infección de la Herida Quirúrgica/diagnóstico , Desbridamiento/métodos , Esternotomía/efectos adversos , Esternotomía/métodosRESUMEN
Identification of a person by general group characteristics does not lose its relevance over a long period. An analysis of publications (2000-2023) devoted to the possibilities of using the sternum to determine gender and age showed a fairly large amount of work on this topic, with very promising results. The trend in the development of this area is the use of modern methods of medical imaging. This becomes the starting point for conducting such studies on the territory of the Russian Federation and developing a methodology that includes the Russian population, taking into account their population characteristics.
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Antropología Forense , Esternón , Esternón/diagnóstico por imagen , Esternón/patología , Esternón/anatomía & histología , Humanos , Antropología Forense/métodos , Determinación de la Edad por el Esqueleto/métodos , Determinación del Sexo por el Esqueleto/métodos , Femenino , Masculino , Federación de RusiaRESUMEN
1. Keel bone damage, such as deformations and fractures, is a severe problem regarding animal welfare in layers. To identify risk factors under commercial conditions, 33 layer flocks (22 barn, 11 free range) with white (n = 18), brown (n = 11) and mixed (n = 4) genotypes were examined.2. Keel bone status was frequently scored by palpation throughout the laying period. Data on housing and management conditions were collected. Multiple regression and Generalized Estimating Equations procedure were used for analysis.3. At 65-74 weeks of age, the prevalence of keel bone damage ranged between 26% and 74%. White genotypes and those kept in multi-tier systems developed significantly (p < 0.05) more keel bone damage than brown genotypes or those kept in single-tier systems. Wing feather condition was associated with keel bone damage (p < 0.05), while other investigated variables regarding health, housing and management were not associated.4. In conclusion, housing and management should be adapted to meet the birds' specific needs in multi-tier systems, which may vary for brown and white genotypes. Whether those differences result from genotype associated predispositions or other individual traits remains to be determined.
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Crianza de Animales Domésticos , Pollos , Animales , Pollos/fisiología , Pollos/genética , Estudios Longitudinales , Femenino , Crianza de Animales Domésticos/métodos , Vivienda para Animales , Esternón/lesiones , Esternón/patología , Enfermedades de las Aves de Corral/epidemiología , Enfermedades de las Aves de Corral/patología , Enfermedades de las Aves de Corral/genética , Factores de Riesgo , Bienestar del Animal , Genotipo , Fracturas Óseas/veterinaria , Fracturas Óseas/epidemiologíaRESUMEN
OBJECTIVE: To analyze the results of simultaneous surgical treatment of sternomediastinitis compared to stage-by-stage approach. MATERIAL AND METHODS: The study included 27 patients between October 2022 and March 2023. All patients underwent heart surgery through median sternotomy. There were 11 (40.7%) women and 16 (59.3%) men. Mean age of patients was 68.4±9.8 years. All patients were divided into 2 groups: 12 patients underwent partial necrectomy and vacuum wound therapy (or long-term dressings) before surgery (group 1), 15 patients underwent surgery without prior conservative treatment (group 2). RESULTS: The most common causative agent of infection was staphylococcus (48.1%). In all patients, we found histological signs of osteomyelitis. Preoperative clinical status was similar in both groups. There were differences in the following indicators: C-reactive protein upon admission - 74.9±18.6 versus 94.8±23.8 mg/l, procalcitonin - 0.13 [0.02; 1.43] versus 0.21 [0.02; 0.94] ng/ml. Postoperative outcomes were similar in both groups. Mortality was 8.3% (n=1) and 13.3% (n=2), respectively. CONCLUSION: Simultaneous combined surgical treatment (sequestrectomy + muscle flap grafting) demonstrates optimal results in the treatment of sternomediastinitis.
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Procedimientos de Cirugía Plástica , Infección de la Herida Quirúrgica , Masculino , Humanos , Femenino , Persona de Mediana Edad , Anciano , Infección de la Herida Quirúrgica/etiología , Esternón/cirugía , Esternón/patología , Colgajos Quirúrgicos , Esternotomía/efectos adversos , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
BACKGROUND: Giant cell tumor (GCT) is a relatively common and locally aggressive benign bone tumor that rarely affects the sternum. CASE PRESENTATION: We report a case of giant cell tumor of the sternum in a 28-year-old Saudi with painful swelling at the lower part of the sternum. Subtotal sternectomy and reconstruction with a neosternum using two layers of proline mesh, a methyl methacrylate prosthesis, and bilateral pectoralis muscle advancement flaps were performed. CONCLUSIONS: Giant cell tumor of the sternum is a rare diagnosis. Surgical resection with negative margins is the ideal management. To avoid defects or instability of the chest wall, reconstruction of the chest wall with neosternum should be considered.
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Neoplasias Óseas , Tumores de Células Gigantes , Humanos , Adulto , Arabia , Arabia Saudita , Esternón/cirugía , Esternón/patología , Colgajos Quirúrgicos , Tumores de Células Gigantes/cirugía , Tumores de Células Gigantes/patología , Neoplasias Óseas/patologíaRESUMEN
This case involves a man with a medical history of multiple myeloma and osseous metastasis of prostate carcinoma. He presented with a progressively growing red tumor on his chest for the past three weeks. Histopathological examination revealed many atypical CD0138-positive plasmablastic cells, which matches a cutaneous manifestation of multiple myeloma.
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Mieloma Múltiple , Neoplasias de la Próstata , Enfermedades de la Piel , Neoplasias Cutáneas , Masculino , Humanos , Neoplasias Cutáneas/patología , Mieloma Múltiple/diagnóstico , Esternón/patología , Neoplasias de la Próstata/patologíaRESUMEN
ABSTRACT: We present 18 F-FDG PET/CT findings of an internal thoracic vein tumor thrombus from melanoma in a 76-year-old woman. Restaging 18 F-FDG PET/CT shows a progressive disease with an internal thoracic vein tumor thrombus from a sternal bone metastasis. Although cutaneous malignant melanoma may metastasize to any body part, a direct tumor invasion of veins and the formation of a tumor thrombus represent an extremely rare complication.
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Neoplasias Óseas , Melanoma , Neoplasias Primarias Secundarias , Neoplasias Cutáneas , Esternón , Trombosis , Humanos , Femenino , Anciano , Metástasis de la Neoplasia , Esternón/patología , Tomografía Computarizada por Tomografía de Emisión de Positrones , Fluorodesoxiglucosa F18RESUMEN
Conventional chondrosarcoma of the chest wall is rare, accounting for 15% of cases. Our purpose was to document clinicopathological, imaging and outcome results from a novel set of chest wall chondrosarcomas, and to analyze for IDH mutations and novel molecular alterations. Gross and microscopic pathology, imaging and clinical charts were reviewed. Targeted next-generation sequencing was performed to identify somatic mutations and copy number alterations. The cohort consisted of 27 patients: 16 men and 11 women (mean age 51 years; range 23-76). Palpable mass was the most common presentation. Five were discovered incidentally. Among 20 tumors with complete imaging, 15 arose from a rib and 5 from the sternum. Seven rib tumors were central/intramedullary, 5 were periosteal, 2 were secondary peripheral chondrosarcomas, and one was indeterminate. Among sternal tumors, 4 were central/intramedullary and one was periosteal. Half the periosteal tumors arose from the costochondral junctional cartilage (CCJ). Periosteal chondrosarcomas were sometimes mistaken for extraskeletal masses on initial clinical or radiological examinations. Fifty-nine percent of all tumors were grade 1 and 41% were grade 2. None were dedifferentiated chondrosarcomas. Heterozygous IDH1 mutation was detected in one tumor and heterozygous RAD50 mutation in another. Local recurrence(s) happened in 41% and metastasis in 41%. Grade had strong association with local recurrence (25% grade 1 vs. 64% grade 2 [P = .0447]), metastatic recurrence (19% grade 1 vs. 73% grade 2 [P = .0058]), and survival. Although chest wall chondrosarcomas share morphologic and molecular features with other chondrosarcomas, there is a much higher incidence of periosteal chondrosarcomas. IDH mutant tumors are uncommon. Early diagnosis and margin-negative resection is treatment of choice since chondrosarcomas are chemo- and radioresistant.
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Neoplasias Óseas , Condrosarcoma , Masculino , Humanos , Femenino , Persona de Mediana Edad , Condrosarcoma/genética , Condrosarcoma/patología , Neoplasias Óseas/genética , Neoplasias Óseas/terapia , Neoplasias Óseas/patología , Mutación , Caja Torácica/patología , Esternón/patologíaRESUMEN
BACKGROUND: Primary sternal chondrosarcoma, although rare, is the most common malignant tumor of the sternum. The gold standard treatment is complete surgical excision, which frequently causes the instability of the thorax necessitating future reconstruction. Local recurrence is common increasing the risk of distant metastasis. CASE PRESENTATION: A 60-year-old male patient was diagnosed with primary sternum chondrosarcoma and underwent surgical excision with negative resection margins. Later, he was found to have two local recurrences at 11 months and 37 months post initial excision. The two recurrences were surgically removed followed by local adjuvant radiation. CONCLUSION: The seeding theories have been reported more frequently with relation to diagnostic biopsy procedures, tumor manipulation and self-seeding tumors. The patient developed two local recurrences despite total resection with negative margins, without concerns regarding seeding in distant metastasis.
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Neoplasias Óseas , Condrosarcoma , Masculino , Humanos , Persona de Mediana Edad , Condrosarcoma/cirugía , Esternón/cirugía , Esternón/patología , Tórax/patología , Recurrencia Local de Neoplasia/cirugía , Neoplasias Óseas/cirugía , Neoplasias Óseas/patología , RecurrenciaRESUMEN
OBJECTIVE: We describe the use of 3-dimensional (3D) printing technology to plan and reconstruct the sternum, adjoining cartilages, and ribs with a custom-made, anatomically designed, 3D-printed titanium implant for an isolated sternal metastasis complicated with a pathological fracture. METHODS: We imported submillimeter slice computed tomography scan data into Mimics Medical 20.0 software and by manual bone threshold segmentation created a 3D virtual model of the patient's chest wall and tumor. For all-around tumor-free margins, we grew the tumor by 2 cm. The replacement implant was designed in 3D using the anatomical features of the sternum, cartilages, and ribs and manufactured using TiMG 1 powder fusion technology. Physiotherapy was provided prior to and following surgery, and the impact of reconstruction on pulmonary functions was assessed. RESULTS: At surgery, the precise resection, clear margins, and a secure fit were achieved. At follow-up, there was no dislocation, paradoxical movement, change in performance status, or dyspnea. There was a decrease in forced expiratory volume in 1 s (FEV1) from 105% prior to surgery to 82% following surgery and in forced vital capacity (FVC) from 108% to 75%, with no difference in the FEV1/FVC ratio, suggesting a restrictive pattern of impairment. CONCLUSIONS: With 3D printing technology, reconstructing a large anterior chest wall defect with a custom-made, anatomical, 3D-printed titanium alloy implant is feasible and safe, and it preserves the shape, structure, and function of the chest wall, albeit with a restrictive pattern of pulmonary function, which can be addressed with physiotherapy.
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Pared Torácica , Humanos , Pared Torácica/cirugía , Titanio , Diseño de Prótesis , Esternón/cirugía , Esternón/patología , Impresión Tridimensional , Costillas/cirugíaRESUMEN
Src homology-2 domain-containing phosphatase 2 (SHP2) is a ubiquitously expressed phosphatase that is vital for skeletal development and maintenance of chondrocytes, osteoblasts, and osteoclasts. Study of SHP2 function in small animal models has led to insights in phenotypes observed in SHP2-mutant human disease, such as Noonan syndrome. In recent years, allosteric SHP2 inhibitors have been developed to specifically target the protein in neoplastic processes. These inhibitors are highly specific and have great potential for disease modulation in cancer and other pathologies, including bone disorders. In this review, we discuss the importance of SHP2 and related signaling pathways (e.g., Ras/MEK/ERK, JAK/STAT, PI3K/Akt) in skeletal development. We review rodent models of pathologic processes caused by germline mutations that activate SHP2 enzymatic activity, with a focus on the skeletal phenotype seen in these patients. Finally, we discuss SHP2 inhibitors in development and their potential for disease modulation in these genetic diseases, particularly as it relates to the skeleton.
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Neoplasias , Fosfatidilinositol 3-Quinasas , Animales , Humanos , Transducción de Señal , Esqueleto , Esternón/patología , MutaciónRESUMEN
Outdoor range areas provide laying hens with improved opportunities to perform natural behaviors and increase the available space per bird, however, birds are also exposed to potentially stressful factors including weather and predators. Ability to cope with challenging environments varies between different strains and must be considered to ensure good welfare. The aim of this study was to determine how suitable 2 hybrids, the Dekalb White (DW) and the Bovans Brown (BB), are for organic production with special emphasis on ranging behavior. A total of 1,200 hens were housed according to organic regulations across 12 flocks of 100 birds. Range and shelter use, effect of weather, vegetation cover, egg production and quality, and mortality were assessed in addition to a range of clinical welfare indicators. Initially a greater proportion of DW hens accessed the range. However, after approximately 2 mo, a greater proportion of BB were using the range and venturing further from the house. DW hens were more likely to use the shelters than BB hens (P < 0.001). Vegetation was also worn away to a greater extent in the BB ranges. Weather affected the proportion of hens that went outside, the distance ranged from the popholes, and shelter use. BB hens were found to have better plumage condition (P < 0.001), fewer footpad lesions (P < 0.001), fewer comb wounds (P < 0.001), and lower mortality rates (P = 0.013). Both hybrids experienced keel bone fractures, though DW hens had more at the cranial portion (P < 0.001) and BB at the caudal portion (P < 0.001). DW hens had an earlier onset of lay and higher egg production than BB hens (P < 0.001), though BB hens laid heavier eggs (P < 0.001) with thicker shells (P = 0.001). Overall, BB hens seemed to perform superiorly or equivalently to the DW hens for all variables apart from egg production. These results demonstrate the importance of considering the strain of bird selected for organic production systems in order for the birds to reap the potential benefits that are offered by outdoor access.
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Fracturas Óseas , Vivienda para Animales , Crianza de Animales Domésticos/métodos , Bienestar del Animal , Animales , Pollos/lesiones , Femenino , Fracturas Óseas/veterinaria , Óvulo , Esternón/patologíaRESUMEN
RATIONALE: Osteosarcoma, a malignant bone tumor, rarely occurs in the sternum, especially the fibroblastic type, and is associated with poor survival. This case report describes a patient with a neoplasm of the sternum who underwent tumor resection 3 times and reconstruction twice because of the high risk of recurrence. PATIENT CONCERNS: A 60-year-old Chinese man presented with a 3-cm palpable bulging mass located in front of his sternum. Chest computed tomography (CT) revealed an anterior chest wall neoplasm with sternal destruction. DIAGNOSIS: Pathological examination revealed that the mass was a low-grade malignant primary fibroblastic osteosarcoma. INTERVENTIONS: Locking plates were used for chest wall reconstruction, demonstrating good structural stability and economic applicability. Regarding the ineffectiveness of current therapies, whole-exome sequencing was conducted, and no targets matched any of the currently available agents. OUTCOMES: No recurrence was found on regular reexamination. LESSONS: Surgery is the first choice of treatment for patients with primary fibroblastic osteosarcoma of the sternum. The reconstruction-locking plate is a good alternative for chest wall reconstruction. Whole-exome sequencing can shed new light on this uncommon disease and help identify novel therapeutic targets.
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Neoplasias Óseas , Osteosarcoma , Procedimientos de Cirugía Plástica , Neoplasias Torácicas , Neoplasias Óseas/patología , Humanos , Masculino , Persona de Mediana Edad , Osteosarcoma/diagnóstico por imagen , Osteosarcoma/patología , Osteosarcoma/cirugía , Procedimientos de Cirugía Plástica/métodos , Esternón/patología , Esternón/cirugía , Neoplasias Torácicas/patología , Neoplasias Torácicas/cirugíaRESUMEN
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Appraise and evaluate risk factors for respiratory compromise following oncologic resection. 2. Outline and apply an algorithmic approach to reconstruction of the chest wall based on defect composition, size, and characteristics of surrounding tissue. 3. Recognize and evaluate indications for and types of skeletal stabilization of the chest wall. 4. Critically consider, compare, and select pedicled and free flaps for chest wall reconstruction that do not impair residual respiratory function or skeletal stability. SUMMARY: Chest wall reconstruction restores respiratory function, provides protection for underlying viscera, and supports the shoulder girdle. Common indications for chest wall reconstruction include neoplasms, trauma, infectious processes, and congenital defects. Loss of chest wall integrity can result in respiratory and cardiac compromise and upper extremity instability. Advances in reconstructive techniques have expanded the resectability of large complex oncologic tumors by safely and reliably restoring chest wall integrity in an immediate fashion with minimal or no secondary deficits. The purpose of this article is to provide the reader with current evidenced-based knowledge to optimize care of patients requiring chest wall reconstruction. This article discusses the evaluation and management of oncologic chest wall defects, reviews controversial considerations in chest wall reconstruction, and provides an algorithm for the reconstruction of complex chest wall defects. Respiratory preservation, semirigid stabilization, and longevity are key when reconstructing chest wall defects.
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Toma de Decisiones Clínicas/métodos , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos , Pared Torácica/cirugía , Algoritmos , Humanos , Esternón/patología , Esternón/fisiopatología , Esternón/cirugía , Traumatismos Torácicos/cirugía , Neoplasias Torácicas/cirugía , Pared Torácica/patología , Pared Torácica/fisiopatologíaRESUMEN
OBJECTIVE: This study aimed to evaluate the therapeutic efficacy of thymectomy through a subxiphoid video-thoracoscopic approach with double elevation of the sternum compared with traditional intercostal uniportal video-assisted thoracic surgery for stage I-II thymic epithelial tumors (using the Masaoka-Koga staging system). METHOD: Patients with thymic tumors underwent resection through intercostal video-assisted thoracic surgery or subxiphoid video-thoracoscopic approach. Only those with pathologically confirmed thymic epithelial tumors were enrolled. Perioperative short-term/long-term outcomes were compared between 2 groups after propensity-score matching. RESULTS: A total of 141 patients diagnosed with thymic epithelial tumors and scheduled for minimally invasive surgery were included. In the intercostal video-assisted thoracic surgery group, the prevalence for conversion to open surgery was higher than in the subxiphoid video-thoracoscopic approach group for stage III thymic tumors (P = .019). After propensity-score matching for 122 patients undergoing video-assisted thoracic surgery, significantly larger resected specimens were found in the subxiphoid video-thoracoscopic approach group compared to the intercostal video-assisted thoracic surgery group (11.7 ± 3.8 vs 7.1 ± 2.7 cm, P < .001). The pain score on the first postoperative day (1.6 ± 0.6 vs 2.0 ± 0.7, P = .011) and the day of hospital discharge (1.2 ± 0.7 vs 1.6 ± 0.6, P = .017) in the subxiphoid video-thoracoscopic approach group were significantly lower. The operation time (168.4 ± 59.3 vs 92.5 ± 46.0 min, P < .001), chest tube drainage time (3.6 ± 1.2 vs 2.9 ± 0.9 days, P = .001), and hospital stay (3.7 ± 1.3 vs 2.9 ± 0.9 days, P = .004) were longer in the subxiphoid video-thoracoscopic approach group, with higher intraoperative blood loss (69.3 ± 61.0 vs 45.6 ± 42.5 mL, P = .045). No significant differences were found in the hospitalization cost, incidence of complications, or 3-year disease-free survival (96% vs 92%, P = .473) between the 2 groups. Four patients with stage III disease in the subxiphoid video-thoracoscopic approach group reached a 3-year disease-free survival of 75%. CONCLUSION: The subxiphoid video-thoracoscopic approach with double elevation of the sternum shows the potential for more extensive clearance of thymic tissue for thymic epithelial tumors compared to intercostal video-assisted thoracic surgery. Its inferior operation time and blood loss could be a trade-off for improved pain control and equivalent hospitalization cost, complications, and 3-year disease-free survival. The subxiphoid video-thoracoscopic approach may offer an advantage treatment for early-stage thymic epithelial tumors and may also be suitable for unexpected advanced thymic tumors identified intraoperatively.
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Neoplasias Glandulares y Epiteliales , Neoplasias del Timo , Humanos , Neoplasias Glandulares y Epiteliales/cirugía , Dolor , Estudios Retrospectivos , Esternón/patología , Esternón/cirugía , Cirugía Torácica Asistida por Video , Timectomía , Neoplasias del Timo/cirugíaRESUMEN
The incidence rate of tuberculosis in developed countries is low. The most common presentation of this disease is its pulmonary form but with the increasing use of immunosuppressive drugs, extra-pulmonary tuberculosis is re-emerging. Nevertheless, sternal bone involvement is uncommon. We report the case of an eighty-three-year-old man who presented a painful sternal mass which progressed towards cutaneous ulceration. The first diagnostic hypothesis was neoplasia. The pathological and microbiological diagnosis of tuberculosis was achieved after surgical biopsy. The patient received treatment against tuberculosis for nine months enabling recovery without surgery. This case illustrates the importance of having a diagnosis prior to any kind of treatment facing any voluminous parietal thoracic lesions. This diagnosis is made possible by surgical samples and interdisciplinary teamwork. This case underlines that tuberculosis remains a differential diagnosis that must be evoked in case of unusual bone mass.
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Ilusiones , Neoplasias Torácicas , Pared Torácica , Tuberculosis , Anciano de 80 o más Años , Humanos , Masculino , Esternón/microbiología , Esternón/patología , Neoplasias Torácicas/diagnóstico , Tuberculosis/diagnósticoRESUMEN
Abnormalities of the sternum and adjacent structures are an uncommon presentation in the paediatric population and can have a variety of benign and malignant causes, including normal and developmental variants of the chest wall. Although there is overlap with adults, many sternal abnormalities are unique to the paediatric population. Following clinical examination, radiography is usually the first type of imaging used; however, it is limited and often ultrasound and cross-sectional imaging are needed for further assessment. An understanding of the normal anatomy is important; however, this can be challenging due to the varied appearances of age-related changes of the sternum. The purpose of this article is to familiarize the general paediatric radiologist with the expected anatomy and imaging findings of the developing sternum, anatomical variants and pathology of the sternum and adjacent structures encountered in this group of patients.
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Enfermedades Óseas , Enfermedades Torácicas , Pared Torácica , Adulto , Enfermedades Óseas/patología , Niño , Humanos , Esternón/diagnóstico por imagen , Esternón/patología , Tomografía Computarizada por Rayos XRESUMEN
Chondrosarcoma is a primary chest wall tumor causing huge masses arising from rib, sternum, or costochondral junction. Successful treatment warrants complete surgical resection with wide, free margins followed by reconstruction of the bony chest wall and soft tissue coverage of the defect. We report the case of excision of giant recurrent sternal chondrosarcoma followed by reconstruction of neosternum using steel wires. This novel technique portrays steel wire-based reconstructions as a safe, reproducible, and readily available prosthetic material for complex chest wall surgeries.