CASE REPORT Sternal Chondrosarcoma After Sternotomy for Coronary Artery Bypass Grafting

OBJECTIVE Primary bony tumors of the chest wall are usually benign and most commonly located in the ribs or sternum. Chondrosarcoma is regarded as one of the most frequent primary malignancies of the chest wall and its incidence after a sternotomy for a cardiac procedure is extremely rare. We present a case of sternal chondrosarcoma. METHODS The patient presented with a sternal mass 4 years after undergoing coronary artery bypass grafting for ischemic coronary artery disease. The mass originally emanated from the upper portion of the patients' sternum and then rapidly enlarged to include the anterior aspects of his neck. Radiologic imaging studies were undertaken: computed tomographic scan and magnetic resonance imaging, with surgical intervention for excision. RESULTS Computed tomographic scan and magnetic resonance imaging established an 8.4 × 6.2 × 8.6 cm(3) complex solid tissue mass within the lower neck arising from the sternal manubrium, with extensive bone destruction. Computed tomography-guided biopsy showed cells of uncertain significance. Surgical excision was performed and the mass was diagnosed as a grade II chondrosarcoma. DISCUSSION Primary sarcomas of the sternum though uncommon are potentially curable with wide surgical excision. Success depends on tumor histologic type and grade, which dictate recurrence.