REMOVING THE TUMOR AND RECONSTRUCTING THE CHEST WALL: A COMPLEX RECONSTRUCTIVE SURGERY WAS PERFORMED AT THE NATIONAL MEDICAL RESEARCH RADIOLOGICAL CENTRE

Sometimes, even before the surgery, the surgeon must not only visualize in detail what needs to be removed but also consider what will be used to replace the resulting defect and how this will be done. The specialists of the Orthopedics Department at the P.  Hertsen MORI – a branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, .required this approach.

The disease had been developing for over a year. Causing virtually no pain or serious functional impairments, the tumor gradually grew to almost 30 centimeters. It became so large that it visibly deformed the chest and even made it difficult for the woman to get dressed.

For a long time, the diagnosis remained unclear: repeated biopsies did not confirm a malignant process. After a telemedicine consultation with specialists from the NMRRC, the patient was offered hospitalization at the P. Hertsen MORI. There, a trephine biopsy of the tumor was performed, which finally allowed the diagnosis — chondrosarcoma — to be established.

“This is the second most common malignant tumor of bone tissue. Its distinctive feature is low sensitivity to drug and radiation therapy, so surgery remains the main treatment method. In our case, it was necessary to remove a large fragment of the chest wall along with the tumor, which means that even before the intervention, we had to understand how we would restore its framework”,- says Artem Bukharov, MD, PhD, head of the Bone and Soft Tissue Tumors Group at the P. Hertsen MORI.

Preparation for the surgery took place virtually. Based on the computed tomography data, the doctors modeled the future resection volume and the size of the defect. Using this model, a custom titanium endoprosthesis for the chest wall was manufactured specifically for the patient on a 3D printer over the course of two weeks.

During the operation, the surgeons removed the tumor in the planned volume and replaced the lost section of the chest with the prepared structure.

“It is fundamentally important for us not just to remove the tumor. The chest wall plays a role in the mechanics of breathing, so after a major resection, it is essential to restore its stability. The custom endoprosthesis is designed for a specific patient and the expected defect. If necessary, we can adapt the structure directly during the surgery. As a result, the chest framework is preserved, and so is its function,” explains Artem Viktorovich.

The patient is now recovering after the surgery. Follow‑up monitoring lies ahead: chondrosarcomas of the chest wall can recur, so regular monitoring is especially important after surgical treatment is completed.

In the meantime, the main change has already taken place: the tumor that the woman lived with for over a year is gone. Now, her dream of returning to a full life is much closer. And the doctors of the national center helped her take the first steps toward that goal.