Chest Wall Chondrosarcoma: Surgical Resection and Reconstruction Using the Strasbourg Thoracic Osteosyntheses System (STRATOS) and Polypropylene Mesh: A Case Report

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Chest wall chondrosarcoma is an uncommon malignant bone tumor for which surgical resection with negative margins remains the primary treatment.Extensive resections may compromise thoracic stability and require complex reconstruction to preserve respiratory function.We report the case of a 62-year-old man who presented with a three-year history of a slowly growing, painless mass in the left costal region.Computed tomography revealed a 9 × 7 cm tumor involving the left tenth and eleventh ribs.Intraoperative findings demonstrated a 12 × 10 cm mass with intrathoracic extension and multiple diaphragmatic nodules.Surgical management included resection of the tumor and the anterolateral portions of the tenth and eleventh ribs, excision of diaphragmatic tissue containing multiple nodules, and diaphragmatic repair.The resulting chest wall defect, measuring approximately 11-12 × 8 cm, was reconstructed using the Strasbourg Thoracic Osteosyntheses System (STRATOS; MedXpert GmbH, Eschbach, Germany) with two titanium bars and polypropylene mesh.Histopathological examination revealed a central atypical cartilaginous tumor/grade 1 chondrosarcoma with positive surgical margins.The histopathological diagnosis of the diaphragmatic lesions was not established in the available report.The postoperative course was uneventful, without reported pulmonary complications.At approximately 10 weeks after surgery, the patient remained asymptomatic.Given the positive surgical margins, radiotherapy was subsequently administered, although treatment details were unavailable.Further pathological assessment was requested, but the results were not documented.This case illustrates the feasibility of chest wall reconstruction using the STRATOS system and polypropylene mesh, with a favorable early postoperative course.However, despite the grade 1 histology, positive surgical margins and the undetermined nature of the diaphragmatic nodules raise unresolved oncological concerns.The limited follow-up of approximately 10 weeks precludes conclusions regarding long-term disease control or reconstructive durability.