The huge tumor has eaten the chest and ribs! Men’s 3D Artificial sternum transformed into “Iron Man”

The man developed a mass on his chest, which grew to the size of his fist in two years. After investigation, he suffered from a rare huge sternal tumor and had to be surgically removed. But the tumor has “eaten” a large part of his sternum and ribs. If the doctor removed the tumor, he would have to sacrifice his sternum and ribs. The man would become a “caveman” and his heart and lung would not be protected.

Wuhan Hanyang hospital thoracic surgery experts boldly try to use 3D technology to print a pair of artificial sternum that fits the patient, so that the titanium alloy “steel” becomes the protective wall of the heart and lung, and the rejection is also small. Yesterday, the patient had a good recovery, but still need radiotherapy and chemotherapy.

The huge tumor has eaten the chest and ribs! Men's 3D Artificial sternum transformed into

Giant tumor eating man’s chest and ribs

Mr. Zeng, 61, lives in Shilipu, Hanyang. Two years ago, he accidentally felt a lump growing on his chest. At that time, it was only the size of his thumb, so he didn’t care much. Until September last year, Mr. Zeng found that the lump was obviously getting bigger and had a tendency to grow madly. Later, a little activity would cause pain and chest tightness, so he rushed to Wuhan Hanyang hospital for treatment.

Professor Wu Zhongquan, director of thoracic surgery, found that Mr. Zeng’s chest mass was the size of an adult’s fist and protruded outward along the chest wall. It is suspected to be a sternal tumor with strong erosion. Sure enough, CT and other examinations confirmed that it was a huge sternal tumor. The mass visible on the chest wall was just the tip of the iceberg. In fact, it had eaten Mr. Zeng’s whole sternum and 10 adjacent ribs.

This makes experts feel a dilemma: if the tumor is not resected in time, it may grow rapidly and rupture at any time, which is life-threatening; but if the tumor is resected, the sternum and ribs will also be removed, forming a huge defect in the chest wall, and the heart and lung will lose the protective wall. A hug or a slight collision may cause fatal injury to Mr. Zeng.

Reconstruction of protective wall with 3D Artificial sternum

The only solution is to find a suitable alternative material to reconstruct the chest wall. The traditional method is to use titanium mesh, but its structural strength is low, the secondary molding is difficult, and the shape is not beautiful. After many discussions, the thoracic surgery team of our hospital put forward a bold proposal: using 3D printing technology to customize a titanium alloy sternum for patients.

After communicating with the patient’s family members, Professor Wu Zhongquan’s team quickly found the relevant manufacturers, obtained the patient’s sternum size, shape and other data with the help of CT scanning and other image results, and delimited according to the surgical resection range. The doctors and engineers carefully designed and repeatedly modified the sternum to make the titanium alloy sternum more accurate and achieve a seamless effect. Seven days later, this pair of “steel and iron bone” was finished, and finally it was treated with strict medical treatment.

The extreme news reporter saw that the sternum was metallic gray, printed in one piece, without any connection. The sternum was replaced by the main skeleton in the middle, and five “ribs” were designed on each side. Why titanium alloy? Professor Wu Zhongquan explained that titanium alloy materials have good compatibility with human body, low rejection probability, much stronger strength than human bones, and lighter weight, which will not cause discomfort of chest compression.

After the cure, the security check will not be affected

At the beginning of January this year, Professor Wu Zhongquan led the team to remove Mr. Zeng’s sternal tumor first, and then repair the defect of chest wall. Professor Wu found that cystic necrosis had occurred in the tumor part during the operation, so he carefully separated the bone tumor and the eaten sternum and rib tissue. The whole removed part was the size of a football, and then it would oppress the heart, lung and large blood vessels.

After hemostasis and disinfection, experts put the 3D Artificial sternum into Mr. Zeng’s body, fixed it with the residual sternum handle, and reinforced it with 10 rib sections one by one. The operation was completed in less than 2 hours. At present, Mr. Zeng’s cardiopulmonary function has recovered. Since the tumor is a plasmacytoma of the sternum and has invaded the bone cortex, Mr. Zeng still needs chemoradiotherapy.

“Thoracic surgery sometimes needs to fill the gap, 3D printing is a good solution to the material problem.” Professor Wu said that in the past, 3D printing was mostly used in orthopedics, and it was used to model and copy the lesion site. Now, it has been able to replace the material into the body and accompany it for life. Because of the good compatibility of the material, there will be no rejection reaction after the operation, and it will not affect the patients to have MRI and other imaging examinations and pass the airport security check after the recovery.

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