SURGICAL RESECTION OF ANTERIOR CHEST WALL CHONDROSARCOMA: A CASE REPORT catarinaf.palma@gmail.com

PE023

SURGICAL RESECTION OF ANTERIOR CHEST WALL CHONDROSARCOMA: A CASE REPORT

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Portugal

Poster Exhibition only

Chondrosarcomas are the third most common primary bone malignancy, representing 20–27% of malignant osseous neoplasms. They form a heterogeneous group of cartilage-producing tumors, for which surgery remains the only curative option in nonmetastatic cases. Management in high-volume centers is associated with improved outcomes.

We present the case of a 93-year-old male, with significant comorbidities, including moderate aortic stenosis, prior transcatheter aortic valve implantation (TAVI) with permanent pacemaker dependency due to complete atrioventricular block, which presented in early 2022, with a left retroareolar nodule. An initial unguided biopsy suggested a benign chondroma. Repeated biopsy in July 2023 revealed a low-grade chondrosarcoma. CT imaging showed a 9x7x7cm mass centered on the left anterior chest wall, destroying the 6th and 7th ribs and infiltrating surrounding musculature, with no safe cleavage plane from the pericardium. After multidisciplinary group discussion the patient was proposed for surgery. The patient initially declined surgery due to high perioperative risks. Re-evaluation in April 2024 showed further tumor growth with ulceration and then surgical treatment was accepted.

On July 16, 2025, the patient underwent en bloc resection of the tumor involving the 4th to 6th ribs. Resection included pleural entry and dissection of mediastinal adhesions. Reconstruction was achieved using a cement plate with polypropylene mesh and a pedicled latissimus dorsi flap. No pericardial invasion was observed. A vacuum-assisted closure device was placed, with plans for delayed epithelialization.

This case demonstrates that surgical resection of chest wall chondrosarcoma may be feasible and appropriate in elderly patients following careful multidisciplinary evaluation.