Chondrosarcoma of the Rib Mimicking Malignant Pleural Mesothelioma

Our plain-English summary of Chondrosarcoma of the Rib Mimicking Malignant Pleural Mesothelioma, by M. Furukawa, H. Tao, T. Tanaka, et al (Case Reports in Oncology, 2016).

The study

• Authors: M. Furukawa, H. Tao, T. Tanaka, H. Onoda, T. Murakami, K. Okabe
• Journal: Case Reports in Oncology
• Published: 2016;9(1):11-4
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A 62-year-old man with a history of long-term asbestos exposure was found to have a chest wall tumor invading the sixth rib on chest computed tomography. The computed tomography also revealed multiple plaques in the pleura. Malignant pleural mesothelioma was suspected, and thoracoscopic surgery was performed. Thoracoscopy revealed that the tumor location was extrapleural. Thus, excisional biopsy was performed. The tumor was histologically diagnosed as chondrosarcoma. Additional wide resection of the chest wall, including the fifth, sixth, and seventh ribs, was performed. Chest wall reconstruction was performed with a polypropylene mesh.

In plain English

This case report described a 62-year-old man in Japan with a history of long-term asbestos exposure as a construction worker. He had no symptoms, but a chest CT scan showed a tumor invading the sixth rib and multiple pleural plaques. Malignant pleural mesothelioma was suspected, so thoracoscopic surgery was done to make a definite diagnosis. During surgery the tumor was found to lie outside the pleura. After it was removed, tissue examination showed a chondrosarcoma, a tumor of cartilage-type cells. Surgeons then removed part of the chest wall, including the fifth, sixth and seventh ribs, and repaired the 25 × 10 cm defect with polypropylene mesh. Under the microscope, the removed specimen showed cartilage-type cells of histological grade 1. The tumor had appeared as small as 3 cm on CT, but its cells had spread 17 cm along the sixth rib. The resection margins were free of tumor. The patient recovered without complications. The authors concluded that chondrosarcoma is difficult to diagnose on preoperative imaging and that wide resection is necessary for curative treatment.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: one 62-year-old man treated at the National Hospital Organization Yamaguchi – Ube Medical Center, Japan; dates of treatment not given
• Exposure: long-term asbestos exposure as a construction worker; fiber type and dose not stated
• Main results:
  • In this patient, chest CT showed a pleural tumor invading the sixth rib and multiple pleural plaques
  • Before surgery, the case was misdiagnosed as malignant pleural mesothelioma
  • During surgery, the tumor was found to be outside the pleura (extrapleural)
  • After excisional biopsy, the tumor was diagnosed by histology as chondrosarcoma
  • Wide en bloc resection took in the fifth, sixth and seventh ribs with a 5-cm safety margin along the sixth rib
  • The chest wall defect was 25 × 10 cm and was reconstructed with polypropylene mesh
  • Microscopic examination of the resected specimen (25 × 10 × 5 cm) showed a lobulated growth pattern of cartilaginous cells, histological grade 1
  • The tumor appeared as small as 3 cm on chest CT, but tumor cells had spread 17 cm along the sixth rib
  • The resection margins were free of tumor cells
  • The patient had a good recovery after surgery without complications
• The authors' conclusion: The authors concluded that chondrosarcoma is difficult to diagnose on preoperative imaging and that wide resection is necessary for curative treatment.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Asbestos Exposure, Pleura, Thoracoscopy, Biopsy.

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