胸壁巨大肉瘤切除伴碳纤维人工肋骨重建和背阔肌肌皮瓣移植1例

doi:10.11958/20252793

天津医药 ›› 2026, Vol. 54 ›› Issue (4): 434-437.doi: 10.11958/20252793

胸壁巨大肉瘤切除伴碳纤维人工肋骨重建和背阔肌肌皮瓣移植1例

石岩¹(), 张鹏¹, 张园², 王晨光², 续文栋¹, 陈渊¹^△()

¹ 天津医科大学总医院心胸外科（邮编300052）
² 天津医科大学总医院骨外科（邮编300052）

收稿日期:2025-08-27 修回日期:2025-12-02 出版日期:2026-04-15 发布日期:2026-04-14
通讯作者: ^△E-mail：yuanchen@tmu.edu.cn
作者简介:石岩（1992），男，主治医师，主要从事胸部肿瘤的外科治疗方面研究。E-mail：shiyanbuxian@163.com

One case report of giant chest wall sarcoma resection accompanied by carbon fiber artificial rib reconstruction and latissimus dorsi myocutaneous flap transplantation

SHI Yan¹(), ZHANG Peng¹, ZHANG Yuan², WANG Chenguang², XU Wendong¹, CHEN Yuan¹^△()

¹ Department of Cardiothoracic Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
² Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, China

Received:2025-08-27 Revised:2025-12-02 Published:2026-04-15 Online:2026-04-14
Contact: ^△E-mail：yuanchen@tmu.edu.cn

石岩, 张鹏, 张园, 王晨光, 续文栋, 陈渊. 胸壁巨大肉瘤切除伴碳纤维人工肋骨重建和背阔肌肌皮瓣移植1例[J]. 天津医药, 2026, 54(4): 434-437.

SHI Yan, ZHANG Peng, ZHANG Yuan, WANG Chenguang, XU Wendong, CHEN Yuan. One case report of giant chest wall sarcoma resection accompanied by carbon fiber artificial rib reconstruction and latissimus dorsi myocutaneous flap transplantation[J]. Tianjin Medical Journal, 2026, 54(4): 434-437.

摘要/Abstract

摘要：

胸壁肉瘤是原发于胸壁的恶性肿瘤，其治疗以手术为主导。巨大的胸壁肿瘤术后造成的胸壁缺损，需要进行胸壁重建以维持胸廓的稳定性，防止矛盾呼吸。该文回顾性分析1例复杂的巨大胸壁肉瘤患者，其既往进行过6次胸壁肉瘤手术，接受过化学治疗、放疗、抗血管靶向治疗等治疗，现再次复发。我科联合骨科进行了胸壁肿瘤切除伴碳纤维人工肋骨重建和背阔肌肌皮瓣移植手术。患者术后胸廓稳定，背阔肌肌皮瓣愈合良好。以期为胸壁肿瘤患者的治疗提供参考。

关键词: 胸壁肿瘤, 胸壁重建, 碳纤维人工肋骨, 肌皮瓣移植

Abstract:

Chest wall sarcoma is a malignant tumor that originates in chest wall, and its treatment is mainly based on surgical resection. Large chest wall defects following the excision of extensive tumors necessitate structural reconstruction to preserve thoracic stability and prevent paradoxical respiration. This report presents a complex case of a patient with recurrent giant chest wall sarcoma treated in our department. The patient had previously underwent treatment such as chemotherapy, radiotherapy and anti-angiogenic targeted therapy. This year, the tumor had recurred. Our department, in collaboration with the orthopedic department, performed a chest wall tumor resection accompanied by carbon fiber artificial rib reconstruction and latissimus dorsi myocutaneous flap transplantation. The patient exhibited stable thoracic architecture postoperatively, and the latissimus dorsi myocutaneous flap healed well. This case is presented to provide insights and a potential reference for the management of complex chest wall tumors.

Key words: thoracic wall tumor, thoracic wall reconstruction, carbon fiber artificial ribs, muscle flap transplantation

中图分类号:

R734.4，R655.1

图/表 5

图1 手术前左侧胸壁肿物外观

Fig.1 The appearance of the mass on the left chest wall before the operation

图2 入院时胸部增强CT

Fig.2 Enhanced chest CT on admission

图3 肋骨三维重建左侧3、4、5病理性肋骨骨折（箭头示）。

Fig.3 Three-dimensional reconstruction of ribs

图4 胸壁肿瘤切除和胸壁重建过程 A：碳纤维人工肋骨胸壁重建；B：背阔肌肌皮瓣取材；C：肌皮瓣填充胸壁缺损；D：术后复查胸部CT，箭头示重建的碳纤维人工肋骨。

Fig.4 The process of chest wall tumor resection and chest wall reconstruction

图5 术后肿物标本病理染色结果（HE染色）

Fig.5 Postoperative tumor specimen pathological results (HE staining)

参考文献 14

[1]	MAJEED F A, ALI A, CHATHA S S, et al. Management of malignant chest wall tumors[J]. J Coll Physicians Surg Pak, 2021, 31(7):833-836. doi:10.29271/jcpsp.2021.07.833.
[2]	KAISER L R. Is there an 'ideal' material for chest wall reconstruction?[J]. Eur J Cardiothorac Surg, 2023, 64(6):ezad397. doi:10.1093/ejcts/ezad397.
[3]	江浩, 吴冠文, 黄威, 等. 胸壁肿瘤手术治疗进展[J]. 中华胸心血管外科杂志, 2024, 40(7):438-446.
	JIANG H, WU G W, HUANG W, et al. Progress in surgical treatment of thoracic wall tumors[J]. Chin J Thorac Cardiovasc Surg, 2024, 40(7):438-446. doi:10.3760/cma.j.cn112434-20240201-00033.
[4]	CAPOSOLE M Z, ARUCA-BUSTILLO V, MITCHELL M, et al. Benign metachronous bilateral ovarian and mediastinal teratomas with an elevated alpha-fetoprotein[J]. Ann Thorac Surg, 2015, 99(3):1073-1075. doi:10.1016/j.athoracsur.2014.05.054.
[5]	中国医师协会胸外科医师分会. 胸壁肿瘤切除及胸壁重建手术中国专家共识(2018版)[J]. 中国胸心血管外科临床杂志, 2019, 26(1):1-7.
	Chinese Society of Thoracic Surgeons. Chinese Medical Doctor Association. Chinese Expert Consensus on Thoracic Wall Tumor Resection and Thoracic Wall Reconstruction Surgery (2018 Edition)[J]. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(1):1-7. doi:10.7507/1007-4848.201809058.
[6]	中国医师协会胸外科医师分会纵隔及胸壁学组, 中国研究型医院学会胸外科学专业委员会, 中国医疗保健国际交流促进会肺癌防治分会, 等. 2022纵隔及胸壁肿瘤围手术期及全程化综合诊治中国专家共识[J]. 中国胸心血管外科临床杂志, 2023, 30(3):325-332.
	The Thoracic Surgery Physicians' Branch of the Chinese Medical Association, the Thoracic Surgery Professional Committee of the Chinese Research Hospital Association, the Lung Cancer Prevention and Control Branch of the China International Association for Medical and Health Care Exchange. et al. Chinese expert consensus on perioperative and comprehensive diagnosis and treatment of mediastinal and chest wall tumors in 2022[J]. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(3):325-332. doi:10.7507/1007-4848.202212063.
[7]	CIPRIANO A, BURFEIND W. Management of primary soft tissue tumors of the chest wall[J]. Thorac Surg Clin, 2017, 27(2):139-147. doi:10.1016/j.thorsurg.2017.01.007.
[8]	WANG L, YAN X, ZHAO J, et al. Expert consensus on resection of chest wall tumors and chest wall reconstruction[J]. Transl Lung Cancer Res, 2021, 10(11):4057-4083. doi:10.21037/tlcr-21-935.
[9]	XIE H, LI B, SUN Y, et al. Impact of pleural reconstruction on postoperative outcomes in rib tumor resection:a decade-long retrospective study[J]. Front Surg, 2024, 11:1473791. doi:10.3389/fsurg.2024.1473791.
[10]	FERNÁNDEZ-TRUJILLO L, SANGIOVANNI S, MORALES E I, et al. Sternal cavernous hemangioma and reconstruction of the anterior chest wall:a case report[J]. BMC Surg, 2020, 20(1):288. doi:10.1186/s12893-020-00961-y.
[11]	KHULLAR O V, FERNANDEZ F G. Prosthetic reconstruction of the chest wall[J]. Thorac Surg Clin, 2017, 27(2):201-208. doi:10.1016/j.thorsurg.2017.01.014.
[12]	ZHAO Z Q, ZHU X Q, ZHU M R, et al. Chest wall reconstruction of male:Latissimus dorsi Kiss flap,rectus abdominis flap and Titanium-mesh[J]. Asian J Surg, 2022, 45(7):1443-1444. doi:10.1016/j.asjsur.2022.02.041.
[13]	PONTIKI A A, NATARAJAN S, PARKER F, et al. Chest wall reconstruction using 3-dimensional printing:functional and mechanical results[J]. Ann Thorac Surg, 2022, 114(3):979-988. doi:10.1016/j.athoracsur.2021.07.103.
[14]	JACOB S, POOLEY R A, THOMAS M. Three-dimensional-printed model as a template for chest wall reconstruction[J]. Heart Lung Circ, 2020, 29(10):1566-1570. doi:10.1016/j.hlc.2020.02.004.

胸壁巨大肉瘤切除伴碳纤维人工肋骨重建和背阔肌肌皮瓣移植1例

One case report of giant chest wall sarcoma resection accompanied by carbon fiber artificial rib reconstruction and latissimus dorsi myocutaneous flap transplantation

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