Case report of chest wall reconstruction using biological matrix following resection of a sternal desmoid tumor diagnosed in pregnancy

Desmoid tumors of the chest wall are rare and pose specific challenges in diagnosis, resection and reconstruction. While not known to have potential for metastasis, they have a high risk of recurrence following resection, even with negative margins. Adequate resection has the potential to leave large thoracic defects, the reconstruction of which are technically challenging and often require a multi-disciplinary surgical skill set. We present the case of a 34-year-old woman, diagnosed with desmoid tumor overlying the inferior aspect of her sternum during pregnancy. She underwent resection of the tumor along with the inferior sternum and costal cartilages and subsequent chest wall reconstruction with a biological porcine dermal collagen-based matrix patch (Permacol®) and myocutaneous reconstruction with a transposed, pedicled latissimus dorsi flap. This case demonstrates a novel technique for chest wall reconstruction highlights the complexities of managing these tumors during pregnancy and emphasizes the importance of a multidisciplinary surgical approach.