Segmental sternal resection for metastatic ovarian cancer: surgical technique and clinical outcome

Isolated sternal recurrence from ovarian cancer is exceptionally rare, and its optimal surgical management remains poorly defined. In selected patients with a prolonged disease-free interval and a solitary metastatic lesion, radical resection may provide durable local control while preserving chest stability and respiratory function. This video tutorial describes the surgical technique and clinical outcome of segmental sternectomy performed for a single-site sternal recurrence of ovarian cancer occurring after a disease-free interval of 12 years. Following comprehensive multidisciplinary evaluation and staging confirming isolated disease, an en-bloc segmental resection of the involved sternum was performed. Chest wall reconstruction was achieved using a rigid methyl methacrylate prosthesis, restoring anterior thoracic stability while protecting the mediastinal structures without compromising respiratory mechanics. The postoperative course was uneventful, with satisfactory functional recovery and stable chest wall integrity. At 1-year follow-up, contrast-enhanced computed tomography positron emission tomography demonstrated no evidence of local or distant recurrence. This video tutorial highlights the feasibility and safety of segmental sternectomy with prosthetic reconstruction for highly selected patients with isolated sternal metastasis from ovarian cancer, and emphasizes the importance of individualized multidisciplinary decision-making in the management of uncommon late recurrences.