• Journal of Chest Surgery
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• 제24권8호
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• pp.802-806
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• 1991

Primary neoplasms of the ribs and sternum are rare. Most primary bony chest wall neoplasms are malignant, and chondrosarcoma is the most common malignancy in this location The etiology of chondrosarcoma is unknown. Definitive diagnosis of chondrosarcoma can only be made pathologically. The natural history of chest wall chondrosarcoma is one of slow growth and local recurrence. Most tumors of the sternum require wide resection and reconstruction procedures, with potentially serious postoperative problems. Advances in chest wall reconstruction primarily through refinement in muscle transposition and clarification of the functional anatomy and blood supply of trunk muscles, has resulted in a more aggressive resection of the these tumors . Recently we experienced a case with chondrosarcoma of the sternum. A 56 year-old man was admitted to our hospital due to painless, slowly enlarging mass at the left sternoclavicular junctional area. The chest radiograph strongly suggested an underlying cartilaginous neoplasm owing to the appearance of typical flocculent and curvilinear calcifications within the lesion. On CT of the chest, the tumor exhibited a scalloped or lobulated contour, hypodensity of the nonmineralized component in comparison to adjacent muscle, and characteristic stippled cartilaginous matrix mineralization, also typical for cartilaginous neoplasm. The patient underwent wide resection of the chest wall tumor include with a 2-3cm margin of normal tissue on all sides and the thoracic skeletal defect was reconstructed with polytetrafluoroethylene [Gore-Tex] soft-tissue patch. Soft tissue reconstructive procedure was done with the pectoralis major muscle transposition. The patient had an uneventful postoperative course and discharged without adjuvant treatment such as radiation and chemotherapy.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.39-42
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• 2022

Bilateral pectoralis major myocutaneous (PMMC) flaps are commonly used to reconstruct large chest wall defects. We report a case of large chest wall defect reconstruction using bilateral PMMC flaps augmented with axillary V-Y advancement rotation flaps for additional flap advancement. A 74-year-old male patient was operated on for recurrent glottic squamous cell carcinoma. Excision of the tumor resulted in a 10×10 cm defect in the anterior chest wall. Bilateral PMMC flaps were raised to cover the chest wall defect. For further flap advancement, V-Y rotation advancement flaps from both axillae were added to allow complete closure. All flaps survived completely, and postoperative shoulder abduction was not limited (100° on the right side and 92° on the left). Age-related skin redundancy in the axillae enabled the use of V-Y rotation advancement flaps without limitation of shoulder motion. Bilateral PMMC advancement flaps and the additional use of V-Y rotation advancement flaps from both axillae may be a useful reconstructive option for very large chest wall defects in older patients.

• Journal of Chest Surgery
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• 제12권2호
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• pp.97-100
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• 1979

Primary intrathoracic neoplasms occur frequently, and the most frequent intrathoracic tumors are of pulmonary or bronchogenic origin. Second in frequency are mediastinal tumors, and least frequency or comparatively rare are the neoplasms arising from the wall of the thorax and extending into the thoracic cavity. Of all intrathoracic tumors, fibroma is extremely rare. Recently, we have experienced a huge rapid growing intrathoracic fibroma originating from thoracic wall, which is removed successfully and confirmed histopathologically. Authors present one case of fibroma and discussion with a brief review of the relevant literatures.

• Journal of Chest Surgery
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• 제44권3호
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• pp.269-271
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• 2011

Pilomatrix carcinoma originates in the matrix cell and is marked by exophytic growing and common local recurrence. There is no established treatment for wide local invasion and metastasis of the pilomatrix besides wide surgical resection. We report a case of rapidly progressive pilomatrix carcinoma, which arose around an Eloesser open window with direct invasion to the adjacent tissue.

• Journal of Chest Surgery
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• 제43권4호
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• pp.470-473
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• 2010

윤활막육종은 젊은 성인의 팔, 다리에 호발하는 악성종양이다. 흉막, 폐에 발생하는 윤활막육종은 드물게 보고되고 있으나, 본 증례처럼 흉벽에 생기면서 소아에 발생한 경우는 매우 드물다. 저자들은 소아의 흉벽에 발생한 윤활막종을 수술 치료한 경험을 보고하는 바이다. 현재 환아는 술 후 3년 동안 재발없이 잘 지내고 있는 중이다.

• Journal of Chest Surgery
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• 제45권3호
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• pp.196-198
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• 2012

Granular cell tumors are uncommon soft tissue neoplasm of nerve sheath origin, which are predominately benign. Granular cells can be found at any site in the body including the tongue, skin, subcutaneous tissue, breast, gastrointestinal, and urogenital systems. However, granular cell tumors have only been rarely described in the chest wall. Here we report a case of a granular cell tumor that occurred in the chest wall of a 59-year-old woman, along with a review of the literature.

• Journal of Chest Surgery
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• 제35권8호
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• pp.638-641
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• 2002

저등급의 섬유점액성 육종은 최근에야 진단적 분류가 이루어진, 드문 연부 조직 종양이다. 젊은 성인의 심부연부 조직에서 발생하는 경향이 있으며, 국소 재발이나 원격 전이가 가능하다. 진단적 범주가 확실히 정립되어 있지 않고 특정한 질환명으로 구분되고 있지 않다. 조직학적으로, 주로 소용돌이 양상으로 자라는 방추상세포와 점액성이나 섬유성 기질이 번갈아 관찰되는 것이 특징이다. 형태학적이나 면역조직학적 특징에 대한 세심한 고려가 상기 질환의 진단에 도움이 되며, 다른 양성이나 악성 연부 조직 종양과의 감별에 도움이 된다. 흉백에 발생한 저등급의 섬유점액성 육종을 경험하였기에, 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제40권7호
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• pp.523-525
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• 2007

낭성활액낭종으로도 불리는 낭포성림프관종은 보통 경부와 액와부에 잘 발생하고 출생 시부터 발견되며, 90% 이상의 환자에서 늦어도 2세 이전에 발견된다. 성인의 흉벽에서 발견되는 예는 아주 드문 경우로 알려져 있다. 저자들은 64세의 남자 환자에서 좌 후흉벽에 발생한 낭성림프관종을 치험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제41권2호
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• pp.289-291
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• 2008

다형성 초자화 혈관 확장 종양은 경미한 악성종양의 특성을 가지며 주로 하지의 표재성 연조직에 발생하는 매우 회귀한 종양으로 알려져 있다. 조직학적으로 확장된 혈관 주위에 비 활동성 유사분열의 판(sheet)과 다발(fascicle)로 이루어지면서, 혈철소(hemosiderin)가 점점이 박혀 있는 방추형의 다형성 세포로 이루어진 종양세포로 구성되며, 유사분열이 거의 없는 것이 그 특징적 소견으로 알려져 있다. 저자들은 우측 전 흉부의 종괴 촉지를 주소로 내원한 50세 남자환자에서 상기 질환을 치험하였기에 문헌 고찰과 더불어 보고하는 바이다.

• Archives of Plastic Surgery
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• 제42권3호
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• pp.288-294
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• 2015

Background Surgical ablation for locally advanced breast cancer results in large chest wall defects, which can then be managed with local flaps or skin grafts. The purpose of this article is to evaluate the outcomes of three types of local skin flaps. Methods Among 25 local flaps in 24 patients, 6 were bilateral advancement (BA) flaps, 9 were thoracoabdominal (TA) flaps, and 10 were thoracoepigastric (TE) flaps. Clinical outcomes were compared including complications, the need for a secondary surgical intervention, and the timing of adjuvant therapy. Results The mean defect size was $436.2cm^2$. Two patients with TA flaps and 6 patients with TE flaps developed distal flap necrosis, and skin grafts were needed to treat 2 patients with TE flaps. Radiation was administered to the BA, TA, and TE patients after average postoperative durations of 28, 30, or 41 days, respectively. The incidence of flap necrosis tended to be higher in TE patients, which lead to significant delays in adjuvant radiation therapy (P=0.02). Conclusions Three types of local skin flaps can be used to treat large chest wall defects after the excision of locally advanced breast cancer. Each flap has its own merits and demerits, and selecting flaps should be based on strict indications based on the dimensions and locations of the defects.