Abstract
Solitary sternal metastasis of liposarcoma is extremely rare. We report a case of liposarcoma in the left thigh with solitary sternal metastasis occurred synchronously. A 43-year-old man was referred to our hospital because he felt a left thigh tumor and a chest wall tumor. CT scan revealed the 21-cm diameter tumor in the left thigh and the 5-cm diameter tumor in the sternum centering the xiphoid progress. MRI and FED-PET/CT detected no other lesions. Percutaneous needle aspiration biopsies of the leg tumor and the chest tumor revealed malignant soft tissue sarcoma and similar pathologic findings of the specimen taken from the leg tumor to those of the sternum tumor. We diagnosed these tumors as left leg soft tissue sarcoma and solitary metastasis of the leg tumor to the sternum. And so we performed extensive resections for the sarcoma in the left thigh conserving the affected leg, followed by resection of the sternal metastasis. The bilateral costal cartilages were resected by keeping a 3-cm distance from the tumor, the body of sternum was resected along with bilateral internal thoracic artery and vein at the hight of the 4th intercostal spce, and the full thickness of the thoracic wall was removed. Reconstruction was conducted by using a femoral myocutaneous flap. The postoperative course was uneventful. Pathology revealed myxoid/round cell liposarcoma and sternal metastasis. Histopathologically, no cancer cells were involved in the surgical margin. Adjuvant chemotherapy was started three weeks after the operation, however, one month after the surgery, MRI revealed multiple spinal metastases.
