PMC7649591_01
Initial radiographic findings showed that (A) the tumor was located adjacent to the 2nd-4th rib and (B) extends into the mediastinal cavity with no attachment to the lung parenchyma.
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Chest X-ray and contrast-enhanced CT evaluation (Fig. 1) revealed cauliflower-like mass on the anterior costochondral junction of the 3rd right rib, 7.7 x 9.9 x 11.39 cm in size, which was reported as a suspected chondrosarcoma.
(A-B) Lateral and upper view of the lump and the preparation for wide excision. (B) The removed tumor along with the 2nd-4th rib.
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The patient then underwent wide excision procedure in supine position with a pad propped under the right shoulder into a slight left decubitus state (Fig. 2a, b). It was removed along with the 2nd-4th ribs with 2.5 cm free margin to the adjacent soft tissue (Fig. 2c).
(A) Implantation of the titanium mesh. The sides were fixed to the ribs ends and sternum with steel wire. (B) Radiologic evaluation following the implantation procedure.
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Each sides of the defect were overlapped by the prosthesis by 1-2 cm (Fig. 3).
Microscopic evaluation demonstrated (black arrow) myxoid area with loosely-arranged cells and (yellow arrows) ovoid fibroblastic mesenchymal cells in swirling, whorled pattern.
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Pathology evaluation of the initial biopsy tissue demonstrated characteristics of a myxofibrosarcoma (Fig. 4).