Giant chondroma of the sternum mimicking a mediastinal mass.

A 64 year old man with a giant benign sternal chondroma presented with cough as his sole complaint. Primary benign sternal tumours are uncommon."2 O'Neal and Ackerman3 reviewed 85 cartilaginous lesions of ribs and sternum that had been reported up to 1950 and added 11 of their own. Eight of the 96 cases were reported to be benign tumours of the sternum, though the benignity was questioned in four. Of 2000 primary bone tumours reviewed by Pascuzzi et al4 in 1957 in the Mayo clinics, only one sternal tumour was classified as benign. In a review of 134 cases of tumours of the thoracic skeleton in 1966 only one lesion of the sternum was benign (eosinophilic granuloma).5 Sabanathan et al found two benign sternal chondromas among 53 primary chest wall tumours.6 Additional isolated cases of benign sternal tumours have been reported.78 In reviews before 1940 many benign cartilaginous neoplasms of ribs and sternum with repeated recurrences were described. Of 36 patients listed as having a benign tumour before 1950, only three were alive and well five years after surgery.4 We report a case of giant benign sternal chondroma. Institute of Pulmonary Medicine G Fink S Spitzer Department of Pathology I Avidor Department of Thoracic and Cardiovascular Surgery, Beilinson Medical Center, Petach-Tikva, Sackler School of Medicine, Tel-Aviv University M Levy Department of Medicine C, Hasharon Hospital, PetachTikva, Israel M Bergman Address for reprint requests: Dr Gershon Fink, Institute of Pulmonary Medicine, Beilinson Medical Center, Petach-Tikva 49100, Israel. Accepted 5 March 1990 Case report A 64 year old non-smoking carpenter complained of a non-productive cough and dyspnoea on exertion of two months duration. He had a history of hypertension, treated by amiloride hydrochloride and hydrochlorthiazide, and type II diabetes mellitus, treated by glibenclamid. On physical examination the patient appeared well and the only abnormality was distended jugular veins. The lungs were clear. A chest radiograph showed a large mediastinal shadow bulging on both sides of the mediastinum, more towards the left side (fig la). Computed tomography of the chest showed a large retrosternal mass in the anterior and middle mediastinum (fig lb). Pulmonary function tests showed a restrictive ventilatory impairment (vital capacity 67% and total lung capacity 72% of predicted values). The maximal flow rates were normal. There was mild hypoxaemia (arterial oxygen tension 9 0 kPa) and normal carbon monoxide transfer factor. A median sternotomy disclosed a large (a)