Radical resection of chest wall tumor followed with sternum reconstruction using titanium bars bridging and skin grafting: two case reports

Introduction and importance: Chest wall tumors pose complex challenges for both resection and reconstruction, particularly when involving extensive soft tissue or bony structures. Achieving stable, functional, and aesthetically acceptable outcomes requires a tailored surgical strategy based on the location and extent of the defect. Case presentation: We report two male patients with chest wall tumors treated at a tertiary referral center in Vietnam. The first patient, with metastatic invasion of the sternum, underwent radical tumor resection, sternal reconstruction using titanium bars and Prolene mesh, and split-thickness skin grafting (STSG) for coverage. The second patient, presenting with a large dorsal soft tissue tumor, was managed with wide excision and reconstruction using a local rotational muscle flap. Both patients had uneventful recoveries and favorable functional and cosmetic outcomes. Clinical discussion: The two cases highlight the versatility of reconstructive approaches in chest wall surgery. Rigid prosthetic materials such as titanium bars are effective for anterior defects involving skeletal structures, whereas local muscle flaps suffice for posterior soft tissue defects. STSG can complement flap or mesh-based reconstructions when deeper layers are adequately supported. The choice of reconstruction should consider anatomical location, defect complexity, and patient comorbidities. Conclusion: Successful chest wall reconstruction after tumor resection relies on individualized surgical planning. A combination of prosthetic materials, flaps, and skin grafts can be tailored to achieve oncologic control, structural stability, and satisfactory recovery depending on the defect characteristics.