DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20190805

An unusual occurrence of giant primary osteosarcoma of chest wall in adult: case report and review of literature

Jeetendar Paryani, Sameer Gupta, Parijat Suryavanshi, Shashi Singh Pawar

Abstract


Osteosarcoma is most frequently occurring bone malignancy which commonly occurs in the ends of the long bone. Usually osteosarcomas do not involve the bones of the chest wall. 22 year old patient presented with swelling in left anterior chest wall gradually enlarging over the period of 1 year accompanied by dull aching pain in the same. On examination there was 30×25 cm large hard irregular swelling which was fixed to chest wall. CECT Thorax was suggestive of 30×25×18 cm sized soft tissue lesion involving 3, 4, 5 rib involvement with sunburst periosteal reaction. Mass is having large extrathoracic with small intrathoracic extensions. Moderate pleural effusion was noted. Core biopsy of mass identified the tumor as osteosarcoma. Primary malignant bone tumors of the chest wall are very rare entity. Of these tumors chondrosarcomas are the most frequent. Chondrosarcoma are chemo-resistant as compared to osteosarcomas. Management of such tumors should follow the same oncological principles of resection with wide margins whenever possible. Neoadjuvant chemotherapy may be given in cases of responsive etiologies like Ewing sarcoma or osteosarcoma. These malignancies generally have poor prognosis.

 


Keywords


Giant, Osteosarcoma, Chest wall, Rib

Full Text:

PDF

References


Krishnamurthy A, Arulmolichelvan A. The Management Challenges in an Unusual Case of Primary Osteosarcoma of the Rib in an Adult Patient. Ind J Surg. 2017;79(4):363-6.

Friesenbichler J, Leithner A, Maurer-Ertl W, Szkandera J, Sadoghi P, Frings A, et al. Surgical therapy of primary malignant bone tumours and soft tissue sarcomas of the chest wall: a two-institutional experience. Int Orthop. 2014;38(6):1235-40.

Low-grade central osteosarcoma of the rib.Yamaguchi T, Shimizu K, Koguchi Y, Saotome K, Ueda Y. Skeletal Radiol. 2005;34(8):490-3.

Surgical treatment of primary malignant chest wall tumours.Sabanathan S, Shah R, Mearns J. Eur J Cardiothorac Surg. 1997;11(6):1011-6.

Kellie SJ, Pratt CB, Parham DM, Fleming ID, Meyer WH, Rao BN. Sarcomas (other than Ewing’s) of flat bones in children and adolescents. Cancer. 1990;65:1011.

Bay SB, Kebudi R, İribaş A, Ömer Görgün, Fulya Ağaoğlu, Feryal Gün, et al. Osteosarcoma of the rib: A rare presentation. Turk Pediatri Ars. 2018;53(1):57-60.

Xie P, Huang J. Primary Osteosarcoma of the Rib Identified on Bone Scintigraphy. Clin Nucl Med. 2016;41(5):390-1.

Xu G, Zheng K. Successful management of early recurrence after surgery for primary rib osteosarcoma in an adult. Interact Cardiovasc Thorac Surg. 2013;17(2):431-2.

Misiak P, Jabłoński S. High-grade surface osteosarcoma of the rib-a case report. Pol Merkur Lekarski. 2015;39:40–2.