Pulsatile sternal tumor: report of three cases and a review of the literature.
At our institution, 3 patients with pulsatile sternal tumor have been seen. Although ascending aortic aneurysm frequently is high on the list of differential diagnoses, the likelihood that this tumor is metastatic from either a primary renal or thyroid neoplasm is overwhelming. Of the 15 patients reported, 11 had metastases from a primary renal cell carcinoma, including all 3 of our patients. There were 2 patients with primary myeloma, the only histologically proved primary pulsatile sternal tumor. From the surgical standpoint, only the patient with metastatic renal cell carcinoma has a chance of cure. With the recent report of 2 5-year survivors and our own experience of 1 patient with a long asymptomatic interval following resection of the primary kidney tumor and the secondary sternal metastasis, the attitude of hopelessness for these patients should be challenged and an aggressive approach considered.
D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008297:Male; D013249:Sternum; D013899:Thoracic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D013964:Thyroid Neoplasms / Q000473:pathology