Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Solitary metastatic adenocarcinoma of the sternum treated by total sternectomy and chest wall reconstruction using a Gore-Tex patch and myocutaneous flap: a case report | Daliakopoulos et al. Journal of Medical Case Reports 2010 4 75 http content 4 1 75 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Solitary metastatic adenocarcinoma of the sternum treated by total sternectomy and chest wall reconstruction using a Gore-Tex patch and myocutaneous flap a case report Stavros I Daliakopoulos1 Michael N Klimatsidas2 Reiner Korfer1 Abstract Introduction The consequences of bone metastasis are often devastating. Although the exact incidence of bone metastasis is unknown it is estimated that 350 000 people die of bone metastasis annually in the United States. The incidence of local recurrences after mastectomy and breast-conserving therapy varies between 5 and 40 depending on the risk factors and primary therapy utilized. So far a standard therapy of local recurrence has not been defined while indications of resection and reconstruction considerations have been infrequently described. This case report reviews the use of sternectomy for breast cancer recurrence highlights the need for thorough clinical and radiologic evaluation to ensure the absence of other systemic diseases and suggests the use of serratus anterior muscle flap as a pedicle graft to cover full-thickness defects of the anterior chest wall. Case presentation We report the case of a 70-year-old Caucasian woman who was referred to our hospital for the management of a retrosternal mediastinal mass. She had undergone radical mastectomy in 1999. Computed tomography and magnetic resonance imaging revealed a X X mass in the anterior mediastinum adjacent to the main pulmonary artery the right ventricle and the ascending aorta. We performed total sternectomy at all layers encompassing the skin the subcutaneous tissues the right pectoralis major muscle all the costal cartilages and the anterior part of the pericardium. The defect was immediately closed using a mm Gore-Tex cardiovascular patch combined with a serratus .
