Sternocostal Research Articles

Resection and Reconstruction Operation of the Sternum A Case Report of Giant Cell Tumor

21-year-old man was admitted to the Department of Orthopaedic Surgery, Kyushu University with a 3 year old history of pain and bulging out of the sternum. A marked balooned out cystic lesions of the corpus sterni was demonstrated. Giant cell tumor Type II was confirmed on histological examination.After en bloc resection of the corpus sterni including both II, III, IV costosternal joints and lower part of manubrium. Three pieces of big iliac grafts were fixed to cover the defect as reconstruction operation.Six months postoperatively, roentgenograms were satisfactory with evidence of bony barrier formation. The patient's course continued to be satisfactory.

Relapsing Polychondritis

Two cases of relapsing polychondritis are described, both with a high E.S.R. and without reaction to antibiotics. Both patients are men, 80 and 72 years old and both with malignant disease besides the chondral condition. One case had affection of both external ears with proved histopathological findings. The second case had affection of the cartilages in the larynx, trachea, nose and sterno-costal joints—and sclerokeratitis. According to the literature, the characteristic of the disease is inflammation of the cartilages, most frequently in the external ears, nose, airways and sterno-costal joints—as well as inflammation in the eyes. Pathognomonic laboratory findings are missing, but a high E.S.R. is the rule. Exacerbations and remissions are typical. The etiology is unknown— auto-immunity has been discussed, as also has enzymatic disorder. Corticosteroids are effective and prevent dramatic obstructions of the airways and destruction of cartilage.

Right Aortic Arch Simulating a Mediastinal Tumor: A Case Report

Right aortic arch is a developmental anomaly of the large vessels ; the aortic arch lies to the right of the trachea and esophagus instead of the left side. It is frequently associated with cardiac malformations, e.g., Eisenmenger complex, 20-25 per cent of Tetralogy of Fallot)#{176} The diagnosis of right aortic arch becomes important in relation to surgical treatment. This vascular anomaly has also been known to occur independently without producing noticeable symptoms. Many cases have been discovered accidentally during routine chest examination, because of its unusual mediastinal shadow. Roentgenologically, the following features have been enumerated.2’ 1. On a posteroanterior chest film, a small mass (right aortic knob) is observed below the right sternoclavicular joint occupying an image position of the left aortic knob. No aortic knob is found at the usual site, the first left costosternal joint. 2. The esophagogram in the posteroanterior view will show left displacement of the esophagus at the height of the right aortic knob, while it is pushed forward in the right oblique view. * Presented at the sixth meeting of the Japanese Circulation Society, the TohokuHokkaido Chapter, Sendai, Japan, June 7, 1958. **From the Katsura Surgical Clinic, Tohoku University, Faculty of Medicine, Sendai Japan.