Chondrosarcoma of the anterior chest wall: surgical resection and reconstruction, our institutional experience


  • Subbiah Shanmugam Department of Surgical Oncology, Kilpauk Medical College, Chennai, Tamil Nadu, India
  • Radha Siva Bharath C. H. Department of Surgical Oncology, Kilpauk Medical College, Chennai, Tamil Nadu, India



Primary chest wall tumours, Chondrosarcomas, Surgical excision


Primary chest wall tumours are not very common. Chondrosarcomas is most common tumour arising from the chest wall. It occurs more often during the third and fourth decade of life. Chondrosarcomas are resistant to conventional chemotherapy and radiotherapy. Wide margin surgical excision remains the best available treatment approach. For chondrosarcomas involving the chest wall, surgical excision may result in chest wall defects that may require reconstruction to obliterate dead space, restore chest wall rigidity, preserve respiratory mechanics, maintain pulmonary function, protect intrathoracic organs, provide soft tissue coverage and minimize deformity. In this article we present a series of 3 cases of chondrosarcoma of anterior chest wall managed at government Royapettah hospital, Kilpauk medical college, Chennai. A 71-year-old male patient, a case of 22×20 cm giant chondrosarcoma arising from anterior left chest wall involving 2nd to 8th ribs. We did wide local excision and reconstruction of chest wall with a synthetic bone cement (methyl methacrylate) construct, sandwiched between two layers of polypropylene mesh.  A 38-year-old male patient, a case of 8×6 cm chondrosarcoma of left anterior chest wall involving 9th rib, we did wide excision of tumor along with 8th, 9th, 10th ribs and defect reconstructed with prolene mesh.  A 37-year-old male patient, a case of 5×4 cm chondrosarcoma arising from left 4th rib. We did wide excision along with 4th rib and primary closure. Patients with chondrosarcomas generally have a good prognosis when optimally diagnosed and treated. Our case series is interesting due to the different sizes of chondrosarcomas at presentation, which are managed differently. Complete resection with wide surgical margin remains the best available treatment, but post resection chest wall reconstruction is posing a great surgical challenge.


Tukiainen E. Chest wall reconstruction after oncological resections. Scand J Surg. 2013;102(1):9-13.

Rascoe PA, Reznik SI, Smythe WR. Chondrosarcoma of the thorax. Sarcoma. 2011;2011:342879.

Kawana S, Yamamoto H, Maki Y, Sugimoto S, Toyooka S, Miyoshi S. Reconstruction of anterior chest wall with polypropylene mesh: two primary sternal chondrosarcoma cases. Acta Med Okayama. 2017;71(3):259-62.

Sangma MM, Dasiah S. Chondrosarcoma of a rib. Int J Surg Case Rep. 2015;10:126-8.

Chang RR, Mehrara BJ, Hu QY, Disa JJ, Cordeiro PG. Reconstruction of complex oncologic chest wall defects: a 10-year experience. Ann Plast Surg. 2004;52(5):471-9.

Arnold PG, Pairolero PC. Chest-wall reconstruction: an account of 500 consecutive patients. Plast Reconstr Surg. 1996;98(5):804-10.

Mansour KA, Thourani VH, Losken A. Chest wall resections and reconstruction: a 25-year experience. Ann Thorac Surg. 2002;73(6):1720-5.

Losken A, Thourani VH, Carlson GW. A reconstructive algorithm for plastic surgery following extensive chest wall resection. Br J Plast Surg. 2004;57(4):295-302.

Hameed A, Akhtar S, Naqvi A, et al. Reconstruction of complex chest wall defects by using polypropylene mesh and a pedicled latissimus dorsi flap: a 6-year experience. J Plast Reconstr Aesthet Surg. 2008;61(6):628-35.

Netscher DT, Baumholtz MA. Chest reconstruction: I. Anterior and anterolateral chest wall and wounds affecting respiratory function. Plast Reconstr Surg. 2009;124(5):240e-52.

Khullar OV, Fernandez FG. Prosthetic reconstruction of the chest wall. Thorac Surg Clin. 2017;27(2):201-8.

Ng CS. Recent and future developments in chest wall reconstruction. Semin Thorac Cardiovasc Surg. 2015;27(2):234-9.

Billè A, Okiror L, Karenovics W, Routledge T. Experience with titanium devices for rib fixation and coverage of chest wall defects. Interact Cardiovasc Thorac Surg. 2012;15(4):588-95.

De Palma A, Sollitto F, Loizzi D. Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system. J Thorac Dis. 2016;8(3):490-8.

Salo JTK, Tukiainen EJ. Oncologic resection and reconstruction of the chest wall: a 19-year experience in a single center. Plast Reconstr Surg. 2018;142(2):536-47.






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