• Shaozi Fu, Yile Zhou, and Heyun Xu.
• Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
• Medicine (Baltimore). 2022 Feb 18; 101 (7): e28827e28827.

RationaleOsteosarcoma, a malignant bone tumor, rarely occurs in the sternum, especially the fibroblastic type, and is associated with poor survival. This case report describes a patient with a neoplasm of the sternum who underwent tumor resection 3 times and reconstruction twice because of the high risk of recurrence.Patient ConcernsA 60-year-old Chinese man presented with a 3-cm palpable bulging mass located in front of his sternum. Chest computed tomography (CT) revealed an anterior chest wall neoplasm with sternal destruction.DiagnosisPathological examination revealed that the mass was a low-grade malignant primary fibroblastic osteosarcoma.InterventionsLocking plates were used for chest wall reconstruction, demonstrating good structural stability and economic applicability. Regarding the ineffectiveness of current therapies, whole-exome sequencing was conducted, and no targets matched any of the currently available agents.OutcomesNo recurrence was found on regular reexamination.LessonsSurgery is the first choice of treatment for patients with primary fibroblastic osteosarcoma of the sternum. The reconstruction-locking plate is a good alternative for chest wall reconstruction. Whole-exome sequencing can shed new light on this uncommon disease and help identify novel therapeutic targets.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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