• Archives of Plastic Surgery
• /
• v.50 no.1
• /
• pp.10-16
• /
• 2023

Background The chest wall defects can be caused by various reasons. In the case of malignant tumor resection of the chest wall, it is essential to reconstruct the chest wall to cover the vital tissue and restore the pulmonary function with prevention of paradoxical motion. With our experience, we analyzed and evaluated the results and complications of the chest wall reconstructions followed by malignant tumor resection. Methods From 2013 to 2022, we reviewed a medical record of patients who received chest reconstruction due to chest wall malignant tumor resection. The following data were retrieved: patients' demographic data, tumor type, type of operation, method of chest wall reconstruction of the soft and skeletal tissue and complications. Results There were seven males and six female patients. The causes of reconstruction were 12 primary tumors and one metastatic carcinoma. The pathological types were seven sarcomas, three invasive breast carcinoma, and three squamous cell carcinomas. The skeletal reconstruction was performed in six patients. The series of the flap were eight pedicled latissimus dorsi (LD) myocutaneous flaps, two pectoralis major myocutaneous flap, two vertical rectus abdominis myocutaneous free flap, and one LD free flap. Among all the cases, only one staged reconstruction and successful reconstruction without flail chest. Most of the complications were atelectasis. Conclusion In the case of accompanying multiple ribs and sternal defect, skeletal reconstruction would need skeletal reconstruction to prevent paradoxical chest wall motion. The flap for soft tissue defect be selected according to defect size and location of chest wall. With our experience, we recommend the reconstruction algorithm for chest wall defect due to malignant tumor resection.

• Journal of Chest Surgery
• /
• v.28 no.11
• /
• pp.1075-1078
• /
• 1995

The desmoid tumor has been reported as the most common histologic subtype of soft tissue sarcoma occuring in chest wall and it known to be highly recurrent. The treatment of choice is a radical wide resection including a safe margin of uninvolved structures around the grossly visible tumor. We report a case of chest wall reconstruction using Marlex sandwich and latissimus dorsi musculocutaneous flap after wide resection of desmoid tumor on the chest wall.

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

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.11
• /
• pp.4535-4538
• /
• 2014

Objective: To explore the value of porous titanium alloy plates for chest wall reconstruction after resection of chest wall tumors. Materials and Methods: A total of 8 patients with chest wall tumors admitted in our hospital from Jan. 2006 to Jan. 2009 were selected and underwent tumor resection, then chest wall repair and reconstruction with porous titanium alloy plates for massive chest wall defects. Results: All patients completed surgery successfully with tumor resection-induced chest wall defects being $6.5{\times}7cm{\sim}12{\times}15.5$ cm in size. Two weeks after chest wall reconstruction, only 1 patient had subcutaneous fluidify which healed itself after pressure bandaging following fluid drainage. Postoperative pathological reports showed 2 patients with costicartilage tumors, 1 with squamous cell carcinoma of lung, 1 with lung adeno-carcinoma, 1 with malignant lymphoma of chest wall, 2 with chest wall metastasis of breast cancers and 1 with chest wall neurofibrosarcoma. All patients had more than 2~5 years of follow-up, during which time 1 patient with breast cancer had surgical treatment due to local recurrence after 7 months and none had chest wall reconstruction associated complications. The mean survival time of patients with malignant tumors was ($37.3{\pm}5.67$) months. Conclusions: Porous titanium alloy plates are safe and effective in the chest wall reconstruction after resection of chest tumors.

• Journal of Chest Surgery
• /
• v.28 no.8
• /
• pp.778-783
• /
• 1995

The incidence of chest wall tumor is rare than those of other portions of the body. The chest wall tumors need special attention about their diagnosis and management than other tumors. From March, 1985 to September, 1994, 33 patients with chest wall tumor underwent surgical treatment, and those were consisted of 28 benign tumors and 5 malignant tumors arising from soft tissue, rib and sternum.Benign tumors were included 11 lipoma, 4 cysticercosis, 2 chondroma and 1 each of fibroma, dermatofibroma, osteochondroma, fibrous dysplasia and hemangioma,and 6 other cases. Malignant chest wall tumors were included 2 metastatic carcinoma,1 each of giant cell tumor, chondrosarcoma and epithelioid sarcoma.Sex ratio of male to female was 1.5:1, and the range of age was 16 to 72 years,and the mean age was about 40 years. Clinical manifestations of chest wall tumor were palpable mass[55% , pain[21% ,tender mass[9% , growing mass[9% and asymptomatic[9% .The all cases were treated surgically, the results were as follows:Local excision 16 cases, wide resection 12 cases, wide resection with chemotherapy 3 cases, each one case of wide resection with radiotherapy and wide resection with chest wall reconstruction.

• Journal of Chest Surgery
• /
• v.25 no.12
• /
• pp.1422-1427
• /
• 1992

Askin tumor is rare malignant small round cell tumor that orgins from interconstal nerve of chest in children It was not until 1979 that Askin first reported that tumor. Although few sporadic reports had been reported, its incidence were too low to analize its clinical featurs. That tumors prognosis is so grave that no therapy would success to cure, but early diagnosis and enbloc excision with following combind chemotherapy and radiotherapy will prolong their survival. Other small round cell tumors of chest wall that must differentiate are Ewing`s sarcoma, rhabdomyosarcoma, lymphoma, neuroblastoma and pulmonary bla-stoma. The most prominant histologic charactersistics of this tumor is neuron specific eno-lase which is detected with immunohistochemistry technique, and neurosecretary electron dense granules within cytoplasm. We expirienced a case of Askin tumor occuring 12-year-old female who has huge right lower chest mass with dull chest pain. She have been underwent excision and postoperative radiotherapy. We are following her up for months and there is no evidence of local recurrence.

• Journal of Veterinary Clinics
• /
• v.41 no.1
• /
• pp.24-29
• /
• 2024

A 6-year-old spayed female French Bulldog presented with a left-sided chest wall tumor. Physical examination revealed that the tumor was firmly adhered to the chest wall. A preoperative punch biopsy of the tumor revealed a grade 2 soft tissue sarcoma (STS). On computed tomography, the tumor's dimensions were assessed as 6.5 × 5.7 × 3.5 cm, and it exhibited invasiveness near the tissue surrounding the ninth rib. The tumor size was large in comparison to the dog's chest wall area. Hence, if the traditional wide-margin resection surgery were to be performed, primary wound closure seemed impractical and could potentially result in respiratory function complications. Therefore, considering the extent of tumor invasion and grade, deep margins were established to include the removal of the eighth to tenth ribs, and a 1-cm lateral margin was designated to enable primary wound closure. To reconstruct the chest wall, polypropylene mesh was attached to the adjacent ribs and the remaining muscles were sutured and covered over the mesh. The dog exhibited a rapid recovery beginning the day after the operation. Postoperative biopsy confirmed that the tumor was a grade 2 STS, and the surgical margins were evaluated as incomplete. The owner chose to pursue follow-up observation instead of chemotherapy. In this study, the surgical approach was chosen based on the importance of functional recovery after surgery. Recent research indicates that the tumor grade is more critical for postoperative prognosis than the extent of surgical margins when removing an STS.

• Journal of Chest Surgery
• /
• v.16 no.1
• /
• pp.176-182
• /
• 1983

Malignant lymphoma in chest wall is a rare form of extranodal variety as occasionally localized tumor. The primary site is suggested from rib or soft tissue, but the incidence in rib is higher than soft tissue. The patient, a male, aged 32, noted a swelling and pain over the left lower posterior chest from 3 months prior to admission. Roentgenograms revealed bony destruction in left 9, & 19th ribs posteriorly and associated chest wall mass which was ill defined uncleared margination. Under diagnosis of malignant tumor, the operation was performed and the tumor mass resected widely with en bloc technique than the fascia lata was grafted at chest wall defect. The histology of specimen was disclosed as malignant lymphoma, non-Hodgkin`s diffuse lymphocytic poorly differentiated form. The radio-and chemotherapy were combined post-operatively and the complete remission is acquired.

• Journal of Chest Surgery
• /
• v.47 no.4
• /
• pp.427-430
• /
• 2014

Chondrosarcoma of the chest wall is a rare primary neoplasm found to occur in elderly men. Patients present with an enlarging, painful, anterior chest wall mass arising from either the vicinity of the costochondral junction or the sternum. Treatment includes wide resection with appropriate chest wall reconstruction. We report an unusual presentation of this uncommon tumor occurring as a huge chest wall mass in a young teenage girl.

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