Sternal cavernous hemangioma and reconstruction of the anterior chest wall: a case report
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CASE REPORT
Sternal cavernous hemangioma and reconstruction of the anterior chest wall: a case report Liliana Fernández‑Trujillo1,2* , Saveria Sangiovanni3, Eliana I. Morales2,4, Valeria Marin5,6, Luz F. Sua2,7 and Mauricio Velasquez2,8
Abstract Background: The sternum is considered an unusual tumor site, corresponding to 15% of all thoracic wall tumors. Primary sternal tumors are even rarer and most commonly malignant. We present the case of a young man who con‑ sulted with a painful sternal mass, which after its resection is confirmed to be a cavernous hemangioma. Case presentation: A 39-year-old man, with unremarkable medical history besides a 2-year-long sternal pain, nonirradiated, which worsens over the last few months and is accompanied by the appearance of a sternal palpable mass. On physical exam, there was a bulging of the sternal manubrium, with no inflammatory changes. Thoracic CT scan shows an expansive and lytic lesion of the sternum, compromising the manubrium and extending to the third sterno‑ costal joint, without intrathoracic compromise nor cleavage plane with mediastinal vascular structures. The patient is taken to resection of the mass and sternal reconstruction using prosthetic material and pectoral and fasciocutaneous muscular flaps. Histopathological findings: cavernous hemangioma with negative borders and no other malignant findings. Conclusions: Sternal hemangiomas can cause defects in the bone structure and show an expansive growth, chal‑ lenging the differentiation between a benign or malignant lesion. Therefore, they should be considered malignant until shown otherwise. Management involves radical surgery with curative purposes and posterior reconstruction to improve quality of life, as shown with our patient. Keywords: Sternal cavernous hemangioma, Primary sternal tumors, Surgical resection and reconstruction, Case report Introduction The sternum is considered an unusual tumor site, with an overall incidence of 15% of all tumors of the chest wall [1]. Primary sternal tumors are even rarer and most commonly malignant [2]. Within benign lesions, hemangiomas are described, but they typically affect soft tissues *Correspondence: [email protected]; lilianafernandeztrujillo@gmail. com; [email protected] 1 Department of Internal Medicine, Pulmonology Service, Interventional Pulmonology, Fundación Valle del Lili, Avenida Simón Bolívar, Carrera 98 # 18‑49, Tower 6, 4th Floor, Cali 7600032, Colombia Full list of author information is available at the end of the article
and when bone tissue is compromised, it tends to be the skull or vertebrae [1, 3]. Management is mainly surgical, with wide excisions and reconstruction being the standard of care. Furthermore, the prognosis of patients with benign tumors of the chest wall is excellent after excision [1]. We present the case of a young man who presents to a high complexity institution, with a painful sternal mass, that is diagnosed as a cavernous hemangioma after complete resection.
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