PMC5481619_01
Pre-operative images of the patient's sternal mass.
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F1
This area was non-mobile and non-tender to palpation (Fig. 1).
CT scan of the chest at initial presentation, including axial Fig. (2A) and a sagittal Fig. (2B) views.
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F2
No underlying marrow changes were noted (Fig. 2).
MRI scan of the chest after biopsy. (A) T2 weighted axial slice, (B) T1 weighted sagittal slice, and (C) short tau inversion recovery (STIR) sagittal slice of the chest.
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F3
The mass was seen extending posteriorly with abutment of the left thymus and great vessels (Fig. 3).
Intra-operative image of the chest wall after resection.
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F4
Fig. (4) shows the chest wall after resection and Fig. (5) shows the resected specimen.
(A) Low power view of low cellularity cartilaginous neoplasm pushing into marrow space (left) and circumferentially entrapping bone (right). (B) A high-power view of chondrosarcoma circumferentially entrapping pre-existing lamellar bone, which has also undergone osteonecrosis.(C) Chondrocyte hypercellularity and cytologic atypia in the setting of bony entrapment.
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F6
Final pathology demonstrated neoplastic cartilage surrounding pre-existing trabecular bone with associated osteonecrosis consistent with low grade chondrosarcoma with microscopically negative margins and closest being at 2 millimeters from the superficial skin (Fig. 6).
Follow up CT scan of the chest including axial Fig. (7A) and a sagittal Fig. (7B) views.
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F7
The patient was followed with quarterly physical exams and radiographs and as of 18 months postoperatively has no pain or recurrence noted on a most recent chest CT scan (Fig. 7).