Sternal metastasis from uterine leiomyosarcoma treated by near-total sternectomy and reconstruction with titanium sternal stabilization and fixation systemTama yakın sternektomi ve titanyum sternum stabilizasyonu ve sabitleme sistemi ile rekonstrüksiyon yoluyla tedavi edilen uterus leiomyosarkomu kaynaklı sternum metastazı
ÖZUterus leiomyosarkomları nadir görülen yumuşak doku tümörleridir. Sıklıkla akciğer, karaciğer ve beyin gibi uzak organlara metastaz yapmasına rağmen, nadiren, uterus leiomyosarkomu kaynaklı sternum metastazı meydana gelebilir. Bu yazıda uterus leiomyosarkomu, total abdominal histerektomi ve iki taraflı salpingoooferektomi ile tedavi edilen ve beş yıl sonra sternum metastazı gelişen ve bu metastazı tamamen çıkarılıp aynı seansta onarımı başarıyla yapılan 50 yaşındaki kadın hasta sunuldu.Anah tar söz cük ler: Leiomyosarkom; metastaz; sternum.
ABSTRACTUterine leiomyosarcomas are rare soft tissue neoplasms. Although they have a tendency to metastasize to distant organs, most commonly to the lung, liver and brain, rarely, sternal metastasis from a uterine leiomyosarcoma can occur. In this article, we report a 50-year-old female patient whose uterine leiomyosarcoma was treated with total abdominal hysterectomy and bilateral salphingooopherectomy, and who developed sternal metastasis five years later, which was completely resected and successfully repaired during the same session.Keywords: Leiomyosarcoma; metastasis; sternum.Primary and metastatic tumors of the sternum are uncommon, but either carcinomatous or sarcomatous malignant tumors may metastasize to this area.[1] While surgery is the preferred treatment for the majority of primary sternal tumors, it is controversial for metastatic tumors that reflect disseminated disease. Most cases of sternal metastasis cannot be cured by surgical resection, but curative resection may be possible when the sternum is the only site of metastasis, complete resection with negative margins is possible, and the primary site of the malignant disease is under control.[2]After a wide local excision, rigid prosthetic replacement is necessary to protect the heart, major vessels, and lungs as well as to prevent the paradoxical movement of the resected sternum. Titanium rods are normally used for rigid sternal stabilization because this metal has the advantage of a high strengthto-weight ratio. In addition, and it can aid in the osseointegration process. Furthermore, titanium causes less interference with computed tomography (CT) and can be used safely with magnetic resonance imaging (MRI) due to its nonferromagnetic characteristics. [3] Herein, we present the case of a female patient with a metastatic sternal tumor that was successfully reconstructed via the use of moldable titanium bars and rib clips for sternal stabilization and the application of prolene mesh. Additionally, the bilateral pectoralis major muscle flaps were advanced to cover the soft tissue defect.
CASE REPORTA 50-year-old woman was admitted to our clinic with a slow-growing soft tissue mass on ste...