A 74-year-old male presented with acute hypoxic respiratory failure. He had a previous medical history of hypertension, type 2 diabetes mellitus, and gastro-oesophageal reflux presented with acute hypoxic respiratory failure. The patient was aware of a mass on his sternum for around 18 years prior to presentation and was told by his previous healthcare provider that it was a benign enchondroma. He remained asymptomatic for most of the duration of the mass until he experienced increasing pain and size of the mass, a few months prior to seeing another medical provider.

Diagnosis & management A CT-guided core biopsy was done and revealed well-differentiated chondrosarcoma (As shown in Figure 1). Figure 1 The patient noticed increased weight loss and rapid growth of the mass, shortly after the biopsy. A repeat positron emission tomography (PET)-CT scan showed extensive retrosternal, lung,…