PMC6098239_01
(A) Coronal Reformat of chest CT scan show a huge hypodense soft tissue mass with irregular margins attached to the muscular layer of the chest wall (B) Axial section of the chest CT scan showing a huge hypodense soft tissue mass within the muscular layer of the anterior chest wall with underlying sternal invasion.
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A chest CT scan showed a huge hypodense soft tissue mass within the muscular layer of the anterior chest wall with underlying sternal invasion (Fig. 1).
Immediate preoperative period - Tumor with peripheral areas of necrosis and central yellowish area.
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She was counselled for CWRR and had enbloc excision of the tumor (Fig. 2), part of the pectoralis major muscles, inferior half of the manubrium sterni, sternal body, xiphoid and adjacent costal cartilages (Fig. 3A & B) with a 4 cm tumor-free skin margin.
(A) Chest wall defect reconstructed with methylmethacrylate. (B) After soft tissue reconstruction.
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Prolene meshes (Fig. 4A). Primary closure of soft tissue was achieved by local flap (Fig. 4B).
(A) Sheets of malignant lipoblasts showing myogenic differentiation in highly vascularized stroma. (B) Areas of myogenic differentiation. H&E x 20. (C) Preserved differentiated area around a blood vessel while others show extensive necrosis.
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The histology revealed sheets of malignant lipoblasts with areas of heterologous differentiation predominantly myogenic as well as areas of pleomorphic sarcomatous pattern (Fig. 5).