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06 March 2020 : Case report  USA

Case Report of a Complex Chest Wall Reconstruction with a Cadaveric Achilles Tendon

Unusual clinical course, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents

Peter A. Fedyshin1BF, Michelle Carey1EF, Shazad L. Shaikh2A, James W. Klena3AEF*

DOI: 10.12659/AJCR.920910

Am J Case Rep 2020; 21:e920910

Abstract

BACKGROUND: Chest wall reconstruction is sometimes needed after resection of a thoracic malignancy. Various materials and techniques have been utilized to restore stability and integrity to the chest wall. We report what we believe is the first use of a cadaveric Achilles tendon to restore stability and function to the chest wall of a young woman who underwent chest wall resection and right upper lobectomy for a superior sulcus tumor.

CASE REPORT: A 46-year-old woman underwent resection of her first through fourth right ribs in addition to her right upper lobe for a squamous cell superior sulcus tumor. Because it was felt her right scapula provided sufficient coverage of her resultant chest wall defect, her chest wall was not reconstructed post-operatively. The patient experienced 2 episodes of scapular prolapse into her thoracic cavity several months after her resection. After the second episode, her right chest wall was successfully reconstructed with a cadaveric Achilles tendon to prevent further episodes of prolapse.

CONCLUSIONS: We believe this is the first description of chest wall reconstruction with a cadaveric Achilles tendon. The use of a cadaveric Achilles tendon should be considered for reconstruction of the chest wall after complex resection due to its strength characteristics, resistance to subsequent infection, and availability.

Keywords: Allografts, Pancoast Syndrome, Achilles Tendon, Cadaver, Reconstructive Surgical Procedures, Thoracic Neoplasms, Thoracic Wall

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923