CPT® Code 21630

A radical resection of the sternum, commonly referred to as the breast bone, is a surgical procedure primarily performed to address malignant tumors located in this area. These tumors are classified as primary malignant bone tumors, which are relatively rare, and may include types such as osteosarcoma, chondrosarcoma, myeloma, or malignant lymphomas. The procedure involves making a surgical incision over the sternum and upper chest to gain access to the underlying structures. During the operation, the surgeon meticulously dissects the soft tissues and elevates the pectoral muscles to expose the sternum and rib cage adequately. Once the tumor is identified, the surgeon maps it out to determine the appropriate margins for removal, ensuring that all cancerous tissue is excised. The use of specialized saws and surgical implements allows for the division of the sternum and its complete detachment from surrounding soft tissues, along with the planned margin of ribs. This extensive removal results in a significant defect in the chest wall, necessitating reconstruction to safeguard the lungs and maintain structural integrity. The reconstruction is typically performed immediately following the resection and may involve various materials, such as an iliac crest autograft with internal fixation devices, polypropylene mesh combined with a layer of methylmethacrylate, or an inner acellular dermal matrix secured with a titanium plate and covered by musculocutaneous soft tissues.