Thoracoabdominal Approach for Chest Wall Chondrosarcoma Resection

Primary chest wall sarcomas are rare malignancies that require complete surgical resection, which remains the mainstay of treatment (1). Different histological subtypes, such as chondrosarcoma and Ewing sarcoma, exhibit distinct biological characteristics, therapeutic approaches, and prognoses. The margins of resection are crucial, as R0 resection is associated with significantly better overall survival compared to positive margins. 
 
The authors report a case of chest wall chondrosarcoma arising from the cartilaginous aspect of the sixth and seventh left costochondral joints in a 70-year-old male patient. A J incision was performed to expose the distal part of the sternum and the left chondral arch. The left rectus abdominis muscle was sectioned to fully expose the costochondral joint, which was isolated with limited detachment of the diaphragmatic insertion on the chest wall. Radical resection was then accomplished, and no prosthetic reconstruction was needed due to the limited extent of the resection. The postoperative course was uneventful, and no recurrence was observed at the one-year follow-up. 

References

1. Tanaka S, Nakata E, Ryuko T, Itano T, Tomioka Y, Shien K, Suzawa K, Miyoshi K, Okazaki M, Sugimoto S, Ozaki T, Toyooka S. Primary chest wall sarcoma: advances in surgical management and outcomes. Eur J Orthop Surg Traumatol. 2025 Apr 1;35(1):141.

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