Sternal resection and reconstruction for metastasis due to breast cancer: the Marlex sandwich technique and implantation of a pedicled latissimus dorsi musculocutaneous flap

Autor: Toru Kamata, Kenichi Shimada, Hidetaka Uramoto, Nozomu Motono
Rok vydání: 2019
Předmět:
Sternum
Sternal resection
medicine.medical_treatment
Case Report
030204 cardiovascular system & hematology
Prosthesis
Metastasis
Breast cancer
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
Marlex
Mastectomy
Sandwich technique
General Medicine
Middle Aged
Neoadjuvant Therapy
Bevacizumab
Chemotherapy
Adjuvant
Cardiothoracic surgery
Parasternal line
Female
Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Paclitaxel
lcsh:Surgery
Bone Neoplasms
Breast Neoplasms
Ribs
Polypropylenes
lcsh:RD78.3-87.3
Prosthesis Implantation
03 medical and health sciences
medicine
Humans
business.industry
lcsh:RD1-811
Plastic Surgery Procedures
Surgical Mesh
medicine.disease
Myocutaneous Flap
Surgery
body regions
030228 respiratory system
lcsh:Anesthesiology
Bone Substitutes
Superficial Back Muscles
Reconstruction
Tomography
X-Ray Computed
business
Zdroj: Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery, Vol 14, Iss 1, Pp 1-5 (2019)
ISSN: 1749-8090
DOI: 10.1186/s13019-019-0905-z
Popis: Background The treatment of hemotogenous solitary sternal metastases by breast cancer remains a controversial issue. Sternal resection for select patients might provide good long-term local control. Case presentation A 63-year-old woman was admitted to our hospital with a mass at the sternum and right second to third costochondral cartilage. She had undergone bilateral mastectomy for breast cancer 13 years earlier. A percutaneous biopsy was performed, and the mass was diagnosed as solitary metastasis due to breast cancer. She received two courses of weekly paclitaxel and bevacizumab, and computed tomography (CT) revealed shrinking of the mass in the sternum. We performed surgical resection with curative intent for a multimodality approach. Parasternectomy and removal of the right second and third costochondral cartilage was performed. A prosthesis was created to fill the defect by sandwiching molded methylmethacrylate between polypropylene mesh. The prosthesis was fixed to the cut ends of the costochondral cartilage and the residual sternum. Finally, a harvested latissimus dorsi myoctaneous flap was transpositioned to cover the chest midline wound. Negative surgical margins at the stump of the sternum and costochondral cartilage were revealed. Conclusion Parasternal resection and reconstruction by the Marlex sandwich technique and implantation of a pedicled latissimus dorsi myocutaneous flap for metastasis due to breast cancer was safely performed.
Databáze: OpenAIRE
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