A unique clinical case. Resection of the sternum with replacement with a titanium structure

Dear friends! Very soon, our community’s news feed will be filled with new events, unique stories and complex clinical cases, urgent messages and reviews of 2024! In the meantime, we are happy to remember all the most interesting things that happened at our Center in 2023. Remember, we told you about our surgeons performing a complex resection of the sternum with reconstruction using an individual titanium prosthesis and soft tissues, and removal of the residual thyroid gland? Let’s remember how it happened.

Two surgical teams from the thoracic department and the head and neck department worked simultaneously in the operating room, and several anesthesiologists and resuscitators carefully monitored the patient’s condition. She is 69 years old and A.Tsyb Medical Radiological Research Centre, – branch of the Federal State Budgetary Institution of the «National Medical Research Radiological Centre» of the Ministry of Health of the Russian Federation became her last hope. Here the woman was offered treatment that would affect the rest of her life.

In 2014, she was diagnosed with thyroid cancer. The treatment was successful and for many years she lived quietly, worked and enjoyed life. However, over time, pain in the sternum appeared, which signaled that something was wrong with my health. Unfortunately, doctor told that, discomfort in this area was associated with cardiovascular problems and a proper examination was not prescribed.

Time passed, and a lump began to form in the sternum area, which caused pain and grew rapidly. And the patient decided to contact A.Tsyb Medical Radiological Research Centre, where doctors gave her an accurate diagnosis: follicular thyroid cancer and multiple metastatic foci in both lungs with bone damage.

As the first stage of treatment, the patient underwent radioiodine therapy, after which the lesions in the lungs significantly decreased. This response allowed the doctors to take the serious step of offering the woman a sternum resection with the removal of several ribs and replacing them with a custom-made titanium structure.

Our patient received all treatment within the framework of state guarantees. This also includes the production of an individual titanium prosthesis, the market value of which is very high. It is important to talk about this, people with such problems should know that for treatment there is absolutely no need to travel to another country or go to a paid clinic; they can get free medical care within a department like ours, said Ilya Kolobaev, head of the radiation department and surgical treatment of diseases of the thoracic region of the A.Tsyb Medical Radiological Research Centre.

The surgeons operated on our patient for five hours. The operation began with resection of the ribs: the metastatic lesion reached 9 cm in length and had a very good blood supply. Due to its large size, the formation compressed the heart, which also affected the patient’s general condition. In parallel, another team of thoracic surgeons performed laparoscopic mobilization of the omentum in order to cover the titanium structure with soft tissue. A little later, Dr. Vyacheslav Polkin, head of the department of radiation and surgical treatment of diseases of the head and neck, joined with the team of the patient who removed the remaining part of the thyroid gland.

Next was the key stage, it was necessary to connect the ribs and the prosthesis, everything had to be accurately measured and carefully put in place. Then close it all with part of the gland and sew it up. Throughout the entire operation, a team of anesthesiologists and resuscitators clearly monitored all indicators, monitored blood loss, and took tests in order to monitor the patient’s condition in real time.

The patient will have to undergo further treatment with radioactive iodine, but we have removed the most significant metastasis, which occupies most of the sternum, and now we can talk not only about preserving life, but also about its quality. «If we had not replaced the ribs with the structure, she would not have been able to do even basic things, such as combing her hair, » said Ilya Vladimirovich.

The fact that such treatment in our country can be obtained within the framework of state guarantees is not a miracle and is not an exception to the rule. Registration for consultations with specialists at the National Medical Research Radiological Centre, as before, is carried out by calling the contact center:

• A.Tsyb Medical Radiological Research Centre: +7 (800) 250-87-00
• P. Hertsen Moscow Oncology Research Institute: +7(495)150-11-22
• Scientific Research Institute of Urology and Interventional Radiology: +7 (499) 110-40-67