567 Chest Wall Resection for Desmoid Fibromatosis with Neo Rib Reconstruction Using 3D Printing: A Case Report
C Cohen, N Chandrashekara, V Raj Patil, S Hindiskere, P S Chinder- Surgery
Abstract
Background
Desmoid fibromatosis, also known as desmoid tumor, is a locally aggressive tumour that develops from fascia and musculoaponeurotic tissue. Chest wall desmoid fibromatoses represent 10-20% of all fibromatoses. Surgery is a successful treatment option for desmoid fibromatosis; however it can be difficult depending on the tumour's location or local spread, and post-resected chest wall reconstruction is becoming a new challenge for surgeons in cases involving ribs.
Method
we present a rare case of chest wall desmoid fibromatosis involving right sided 9th rib in a 35-year-old male, which was discovered due to a thoracic wall mass. The patient underwent wide tumour surgical excision of the 9th and part of the 10th rib. To reconstruct a neo rib 3D printing of the rib lesion with 1:1 ratio was done in order to obtain a good orientation. Two cannulated cancellous screws were fixed between the two ends of the resected ribs. A simple sternal wire was anchored between the two screws and bone cement was moulded similar to the rib architecture over the sternal wire.
Results
Post operatively margins were free and lung expansion was satisfactory. 5 year post operative follow up showed no local recurrence.
Conclusions
This case report sheds light on rare tumour of the rib and provides a comprehensive approach towards its surgical management which includes reconstruction of a neo rib with no major complications.
Implications
This technique has helped in reconstruction of the chest wall with very limited and easily available resources.