AUTHOR=Rastrelli Marco , Di Prata Claudia , Marconato Roberto , Del Fiore Paolo , Granziera Elisa , Brunello Antonella , Vindigni Vincenzo , Zuin Andrea , Sbaraglia Marta , Tropea Saveria , Mocellin Simone 

TITLE=Case Report: Surgical Reconstruction of a Massive Thoracic Wall Defect After the Resection of an Undifferentiated Radiation-Induced Sarcoma of the Breast

JOURNAL=Frontiers in Surgery

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.773313

DOI=10.3389/fsurg.2021.773313

ISSN=2296-875X

ABSTRACT=A 54 y-old lady was referred to our institute for a massive thoracic neoplasm arising from the thoracic wall which infiltrated and dislocated the left breast. Twenty years before the patient had undergone a quadrantectomy with axillary dissection for an infiltrating ductal carcinoma of the left breast, followed by adjuvant radiotherapy and chemotherapy.A tru-cut biopsy of the mass showed a low differentiated malignant neoplasm with spindle-shaped cells . The patient underwent a total-body CT-scan which showed a 16x15x10 cm, largely necrotic mass with irregular and undefined margins with little omolateral round-shaped cervical and mesenteric lymph-nodes but no distant metastases.After a multidisciplinary discussion we proposed surgery as first therapeutic option. The planned treatment was a wide excision of the mass with the underlying ribs (II-VI) followed by reconstruction of the thoracic wall using titanium bars covered by acellular porcine dermis, latissimus dorsi flap and finally skin grafts from the thighs.