RADICAL STERNO- COSTAL RESECTION OF SKIN TUMOR AND IMMEDIATE RECONSTRUCTION: A CASE REPORT

Abstract

Purpose: We managed a 30 years old male Albino with Basal Cell Carcinoma of the Sternum with local deep invasion to the Pleura with the aim of offering a cure.

Methodology: Information of the patient from the medical records showed a 30-year-old Albino (Fitzpatrick Skin type I) who was exposed to tropical sun rays for about three decades before presenting with 1-year history of locally advanced sternal skin basal cell carcinoma. This was resected five times in another teaching hospital, but the fungating lesion recurred locally after each attempted local wide excision.

Result: He was found to have 18cm x 22cm malignant ulcer which penetrate over the manubrium and middle of the sternum. It also extended bilaterally to cover the anterior ribs and costochondral joints though his general condition was stable.

Contribution to Theory, Policy and Practice: After detailed investigations and obtaining an informed consent, he had a radical en-bloc resection of the tumor: including the involved sternum and the affected anterior part of the affected pleura. Full thickness reconstruction of the anterior chest wall was done with marlex methacrylate mesh and steel wire support, obliteration of dead space, soft tissue cover with latissimus dorsi pedicle musculocutaneous flap with satisfactory outcome. The use of Stainless wires in our chest reconstruction provided a simpler and cheaper alternative to the use of advanced Tridimensional titanium printed custom made prosthesis, and less morbidity to alternative use of autologous ribs.