Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Malignant Fibrous Histiocytoma in Sternum after Radiation Therapy -Total Sternectomy and Chest Wall Reconstruction, A Case Report-

방사선 치료후 흉골에 발생한 악성 섬유성 조직구종 -흉골 전절제 및 흉벽 재건술 1례 보고-

  • 조유원 (울산대학교 의과대학 서울중앙병원 흉부외과) ;
  • 박승일 (울산대학교 의과대학 서울중앙병원 흉부외과)
  • Published : 1996.01.01
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Abstract

Malignant fibrous histiocytoma after radiation therapy is very rare and its prognosis is poor. A 52-year-old male patient was admitted due to painful mass at the sternal area which developed 6 months ago. The patient had a history of radiation therapy for esophageal cancer 5 years ago. The incisional biopy disclosed sternal sarcoma. In spite of 5 cycles of chemotherapy, the m ss progressively enlarged, and an operation was performed. Total sternectomy with overlying skin and postal cartilage was performed and reconstruction was carried out with autologous rib bone graft, bilateral pectoralis klajor muscle flap and skin graft. The microscopic examination was consistent with malignant fibrous histiocytoma. The postoperative course was uneventful and the patient was discharged on postoperative 36 day.

방사선 치료 후 발생한 악성 섬유성 조직구종은 아주 드물며 일반적으로 예후가 나쁘다. 52세 남자환자가 6개월 전부터 발견된 흉골부위에 발생한 동통성의 종괴을 주소로 입원하였다. 환자는 5년전 식도암으로 방사선 치료를 받은 병력이 있었다. 종괴는 절개생검상 흥골육종으로 진단되어 항암약물요법을 5회 시행하였으나, 종괴가 점점 커져 수술을 시행하였다. 수술은 흥골을 덮고있는 피부와 늑연골을 포함하여 흥골 전절제술을 시행하였고 이로 인한 결손부위는 자가늑골 이식, 양측 대흥근 근육판과 피부이식으로 흥벽재건술을 시행하였다. 수술후 조직소견은 악성 섬유성 조직구종에 일치하였다. 수술후 경과는 순조로왔으며 36일째에 퇴원하였다.

Keywords

References

  1. Cancer v.37 Inflammatory fibrous histiocytoma: An aggressive and lethal lesion Kyriakos,M.;Kempson,R.L.
  2. Cancer v.39 Myxoid varient of malignant fibrous histiocytoma Weiss,S.W.;Erzinger,F.M.
  3. Arch Surg v.127 Radiation-associated sarcoma of bone and soft tissue Brady,M.S.;Gaynor,J.J.;Brennan,M.F.
  4. Mayo Clin Proc v.61 Thoracic wall defects: Surgical management of 205 consecutive patients Pairolero,P.C.;Arnold,P.G.
  5. Arch Surg v.56 Tumors of the sternum: report of a case with special operative technicque Bisgard,J.D.;Swenson,S.A.
  6. Mayo Clin Proc v.53 Chondrosarcoma of monubrium: resection and reconstruction with pectoralis major muscle Arnold,P.G.;Pairolero,P.C.
  7. Mayo Clin Proc v.56 Postradiation sarcoma of bone: review of 78 Mayo Clinic cases Weatherby,P.;Dahlin,D.C.;Ivins,J.C.