• Journal of Chest Surgery
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• v.51 no.5
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• pp.308-311
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• 2018

We herein present a new surgical reconstruction technique for large chest wall defects after resection of advanced chest wall tumors.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.175-181
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• 2003

Primary chest wall tumors originate from soft tissue, bone or cartilage of the chest wall and it comprises 1∼2% of all primary tumors. Resection of tumor is often indicated for chronic ulceration or pain, and long-term survival might be achieved after surgery depending on the histology and the surgical procedure. Material and Method: Retrospective study of 125 primary chest wall tumors (86 benign, 39 malignant) operated between Sep. 1976 to Mar 2001 were reviewed and their clinical outcomes were analyzed. Follow-up data were collected at the outpatient clinic. Result: All patients with benign tumors were treated by excision without recurrence or death, and most malignancies were treated by wide resection. Malignant fibrous histiocytoma and chondrosarcoma constituted 46.2% of the malignant neoplasm. There was no operative death. The overall 3-year survival for patients with primary malignant neoplasm was 76.0%, and the 10-year survival was 60.5%. All deaths were disease-related and the tumor recurred in 11 patients. There was no significant difference in survival between patients with resection margins less than 4 cm and those with resection margins greater than 4 cm. Conclusion: Chest wall resection offers excellent results for benign chest wall tumors and substantial long-term survival for malignant diseases. Safe resection margin of 4 cm or more did not correlate with the survival rate although the tumor recurrence correlated with poor survival.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.246-249
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• 2022

Recurrent pectus excavatum (PE) after a Ravitch operation is not uncommon. Extensive costal cartilage resection from the previous Ravitch procedure can lead to an irregular, unstable chest wall depressions with a varying degree of deformity. The optimal approach to cover the chest wall defect and remodel the deformity, remains unknown. We report the case of a 27-year-old woman seeking surgery for the third time for recurrent PE. The patient presented with 2-time recurrent pectus excavatum following a failed Ravitch procedure and subsequent pectus bar repair. The entire chest wall reconstruction and remodeling entailed covering the chest wall defect with 2 titanium plates across both sides of the rib cage, and lifting and fixing the depressed chest wall with 2 parallel pectus bars.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.472-476
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• 1996

Malignant flrous histiocytoma is a rare deep-seated pleomorphlc sarcoma, although its incidence Increasing. In this report, we present a case of a malignant fibrous histiocytoma, arising in the left chest wall in a 37-year-ol4 male patient. He underwent radical on bloc resection which include excision of tumor on left upper chest wall with resection of ribs from the first to third, left upper lo ectomy and chest wall reconstruction with Marled Mesh. However, he had local recurrence and distant metastasis within 12 months of the original operation. Malignant fibrous histiocytoma is an agrressive disease entity, with a propensity for early and distant spread.

• Journal of Chest Surgery
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• v.8 no.1
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• pp.29-36
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• 1975

We have experienced 49 cases of tumors of chest wall at St. Mary`s Hospital from Jan. 1963 to Dec.1974. In four cases of them, the reconstruction of chest wall defects performed. 1] Out of 49 cases of tumors of the chest wall, 27 cases were benign tumors, 14 cases metastatic malignant tumors, and 8 cases primary malignant tumors. 2] Twenty-six cases [50%] of tumors of the chest wall were on the bony cage. Among them benign tumors were 9 cases [35%], metastatic malignant tumors 14 cases [53%], and primary malignant tumors 3 cases [12%]. Of these, 24 cases were located on the ribs and 2 cases on the sternum.3] The malignant tumors of bony chest wall were excised in en bloc resection including involved ribs. The wide defects of bony chest wall were reconstructed by means of displacement of neighboring ribs and mobilized diaphragm, in the two osteogenic sarcomas of rib, and of prosthesis with silastic sheets in one rhabdomyosarcoma and one metastatic adenocarcinoma of lung.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.277-280
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• 2010

Purpose: The resection of locally advanced or recurred breast cancers frequently result in large chest wall defects and it leads to a great challenges to cover. Generally simple skin grafts are not a practical option for patients because of their poor cosmetic appearance and prognosis. The latissimus dorsi and rectus abdominis musculocutaneous flap have traditionally been recommended for closure of these large defects. Though the cosmetic result of reconstruction using these flaps is often excellent, but has significant drawbacks. Therefore, we thought that chest wall reconstruction using the external oblique musculocutaneous flap can be an alternative method for extensive chest wall defect related to large, locally advanced breast carcinoma. Methods & Results: We present a case of a 50-year-old Korean female, refered to our department with a left breast tumor for 10 months. CT demonstrate a large tumor on the left anterior chest wall and multiple nodules of varying size in the cervical areas and liver. FDG-PET showed areas of hot uptake throughout the left chest wall, mediastinum and liver. Biopsy was consistent with invasive ductal carcinoma (Grade III). The initial tumor was considered inoperable, so a series of chemotherapy was initiated. Though the size of the breast mass was slightly decreased, the patient continued to suffer from purulent discharge, unpleasant odor and contact bleeding of the mass, the salvage mastectomy was performed. Conclusion: We could reconstruct $23{\times}16\;cm$ sized large chest wall defect, resulting from the resection of a locally advanced breast carcinoma, using an external oblique musculocutaneous flap successfully. Immediate postoperatively checked flap was healthy. Overall result was good without any significant complications and discharged 3 weeks after operation.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.155-161
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• 1998

Between January 1979 and August 1996, resection of a primary chest wall tumor was done in 51 patients. The mean age of the patients was 36.1 years(2 to 69 years). A palpable mass was the most common symptom(32 patients, 62.7%). The tumor was malignant in 11 patients (21.6%) and benign in 40 patients(78.4%). The tumors in 32 patients(62.7%) had developed from the bony or the cartilaginous wall and in 19 patients(37.3%) from soft tissue. Thirty seven of the patients with benign tumors were treated by excision (three of the patients: wide resection and reconstruction) without recurrence or death, and they are currently free from disease. Most malignancies(8 patients) were treated by wide resection and chest wall reconstruction. Five of them are currently alive. The chest wall reconstruction with Marlex mesh, Prolene mesh, or Teflon felt was done in five of the patients with malignant tumors. There was no operative or hospital mortality among the total 51 patients.

• Journal of Chest Surgery
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• v.50 no.4
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• pp.308-311
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• 2017

A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.105-111
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• 1998

Double primary cancer is a rare disease in which two cancers occur in an individual independently. As prolonged survival of patients with malignant tumors is expected in the future due to advances in methods of treatment, the chance of double primary cancer will be increased. We experienced one case of double primary cancer which was developed in esophagus and chest wall. A 72 year-old male visited our hospital complaining of epigastric discomfort and right chest wall mass. We studied esophagus, chest wall, and other organs including gastrointestinal tract by various methods to exclude the cancer of other sites and could diagnose squamous cell carcinoma of mid-esophagus and adenocarcinoma of chest wall. The patient underwent esophagogastrostomy following esophagectomy and wide-resection of chest wall tumor. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.11 no.4
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• pp.456-460
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• 1978

Desmoid tumor is found most often in the anterior abdominal wall of parous women. Although it may originate in virtually any musculotendinous structure, those of the chest wall are rare. We experienced a case of large dumb bell shaped desmoid tumor originated in intercostal muscle and invaded anterior chest wall, pericardium, pleura and the lung. The patient was healthy in appearance except a painful swelling on the anterior chest wall. Roentgenographic studies demonstrated a huge homogenous mass in the right anterior chest cavity. He was treated with resection of the tumor including .anterior chest wall, a portion of the pericardium, middle lobe, and part of upper & lower lobes of the right lung because of tumor invasion. The tumor composed with two parts, one [$5{\times}4{\times}3$cm in size] is over the rib cage and another [$10{\times}15{\times}10$cm in size] is in the right chest cavity. Postoperative course was uneventful and there was no evidence of recurrence until last visit, 5 months after surgery.