Abstract
Osteosarcoma is the most common primary malignant tumor of the long bones. However, primary osteosarcoma of the chest wall, particularly the sternum, is an extremely rare occurrence. We report a 36-year-old male presenting with a hard, immobile, palpable, anterior chest wall mass. A computed tomographic (CT) scan showed a large destructive anterior mediastinal mass involving the manubrium and sternum with multiple bilateral calcified lung masses, pleural effusions and partially calcified aortopulmonary, right hilar and subcarinal lymphadenopathy. Incisional biopsy of the mass revealed grade 2 chondroblastic osteosarcoma. The patient underwent one cycle of chemotherapy with ifosfamide and palliative radiation. Unfortunately, the patient was unable to tolerate ifosfamide and developed severe nausea and vomiting requiring the discontinuation of chemotherapy. Given his metastatic disease and inability to tolerate standard chemotherapy, he was referred to a comprehensive cancer center for advanced clinical trials.
Highlights
Primary osteosarcoma of the sternum is an extremely rare tumor, with a reported median age of 42 years at the time of diagnosis [1]
We present a unique case of primary osteosarcoma of the sternum with metastasis to the lungs
Given the aggressive nature of this tumor and the poor prognosis associated with metastatic disease, early diagnosis and management are of paramount importance
Summary
Primary osteosarcoma of the sternum is an extremely rare tumor, with a reported median age of 42 years at the time of diagnosis [1] It is considered an aggressive malignant tumor with poor prognosis [2]. A 36-year-old African American male with no significant past medical history presented to our cancer center with a six-month history of an anterior chest wall mass. He underwent biopsy of the rapidly growing lung lesion which was consistent for chondroblastic osteosarcoma. Given his metastatic disease and inability to tolerate standard chemotherapy, he was referred to a comprehensive cancer center for advanced clinical trials
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