Posters: Surgery Curr Res
Background: Ewing?s sarcoma of the sternum is extremely rare. We report a case of a Ewing?s sarcoma of the sternum that was treated with chemotherapy and surgery. Case report: A 16 year old male had an enlarging chest wall mass, tenderness and a 30 lb weight loss. Patient denied any chest pain or shortness of breath. The child was an otherwise healthy with no history of other medical problems. Computed tomography (CT) scan of the chest showed anterior sternum calcified mass extending into the anterior mediastinum. The mass was biopsied and found to be Ewing?s sarcoma. The patient was treated with 12 cycles of chemotherapy (vincristine, cyclophosamide, and topotecan). The tumor decreased in size by two-thirds its original size. Five months later the tumor was excised in a circumferential fashion with 1.5 cm negative margins. One third of the sternum was removed along with adjacent intercostal muscles and rib ends. The plastic surgery team placed alloderm over the heart, polyprolene mesh, mobilized a left lattisimus dorsi muscle flap and tunneled it under the left chest over the sternal space. Three sternal plates were placed across the sternum. Post-operatively, the patient did well and discharged home on post-operative day 10. The patient has been seen in the clinic and is doing well post- operatively. Conclusion: Ewing?s sarcoma is a rare cancer of the sternum. It can be treated with a combination of chemotherapy and surgery. Ideally, the excision should include 1.5-2 cm margins. A combined effort between oncology, thoracic surgery and plastic surgery for single excision and reconstruction is optimal for the patient.
Ahmed Dehal has completed his medical training at the age of 24 years from University of Baghdad in Iraq. He has also received a Master?s degree in Epidemiology/Clinical Research from Georgia Southern University in Georgia, United States. Dehal has then joined Arrowhead Regional Medical Center/Kaiser Permanente general surgery residency program in California, United States. Currently he is in training as a postgraduate level three. He has published 8 papers in reputed journals during his residency training so far.