PMC8331331_01
Shaped titanium mesh that entirely covers the anterior wall defect.
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F1
The device was fixed by non-absorbable polyfilament stitches inserted between the mesh and the anterior arc of the ribs. The implant was strengthened through myoplasty with pectoral major superiorly and rectus abdominis inferiorly (Figure 1).
(A,B) Preoperative CT of the thorax showed a wide destruction of the upper 2/3 of the sternum by the neoplastic mass; (C,D) Chest X-ray at 40 days displayed the correct positioning of the titanium mesh, perfectly integrated into the wall.
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F2
Computed tomography (CT) of the thorax revealed a lesion in the sternal body (5 x 4cm), involving the manubrium and the body of the sternum and the internal mammary vessels (Figures 2A,B). The 40-day follow-up revealed the perfect mesh tightness with no signs of displacement (Figures 2C,D) and paradoxical movement of the chest.
PMC8331331_02
Preoperative PET/CT displayed a right paramediastinal mass infiltrating the sternal body.
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F3
Positron emission tomography/computed tomography (PET/CT, Figure 3) displayed a standardized uptake value (SUV) max of 6.5 only at site of the lesion.
Titanium mesh resting on a titanium support plate.
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F4
The bony chest wall was stabilized using a 4 mm thick fenestrated titanium mesh (original size 200 x 150 mm), which was fixed to the ribs by prolene stitches and reinforced with a titanium bar in the central part of the prosthesis (Figure 4).