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DOI: 10.1055/s-0031-1275167
Review of Chest Wall Tumors: A Diagnostic, Therapeutic, and Reconstructive Challenge
Publikationsverlauf
Publikationsdatum:
05. April 2011 (online)
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ABSTRACT
Chest wall tumors are a heterogeneous group of lesions that provide an interesting diagnostic and therapeutic challenge for surgeons. They make up less than 5% of thoracic malignancies and vary widely in pathology as they arise from all anatomic structures of the chest wall. In general, treatment is wide local excision, the margins for malignant disease are necessarily wider, and adjuvant radiation is typically given for those with positive margins. Chemotherapy is rarely effective. Local control is the most important prognostic factor. Disease-free survival for malignant disease is limited by positive margins; therefore full oncologic resection with 4-cm margins should be attempted. For small lesions, the resection and reconstruction is usually straightforward. For more advanced disease or those lesions that require significant functional loss, preoperative planning using a multidisciplinary approach, incorporating thoracic surgery, plastic surgery, neurosurgery, radiation medicine, oncology, and physical medicine and rehabilitation, may be essential.
KEYWORDS
Chest wall tumor - primary chest wall tumor - chest wall resection
REFERENCES
- 1 Park B J, Flores R M. Chest wall tumors. In: Shields T W, Locicero J, Reed C E, Feins R H, eds. General Thoracic Surgery. Philadelphia, PA: Lippincott; 2009: 669-678
- 2 Incarbone M, Pastorino U. Surgical treatment of chest wall tumors. World J Surg. 2001; 25 218-230
- 3 Shah A A, D'Amico T A. Primary chest wall tumors. J Am Coll Surg. 2010; 210 360-366
- 4 Tateishi U, Gladish G W, Kusumoto M et al.. Chest wall tumors: radiologic findings and pathologic correlation: part 1. Benign tumors. Radiographics. 2003; 23 1477-1490
- 5 Lee T J, Collins J. MR imaging evaluation of disorders of the chest wall. Magn Reson Imaging Clin N Am. 2008; 16 355-379, x
- 6 Kucharczuk J C, Kaiser L R. Chest wall resections. In: Kaiser L R, Kron I L, Spray T L, eds. Mastery of Cardiothoracic Surgery. Philadelphia, PA: Lippincott; 2007: 222-227
- 7 Ryan M B, McMurtrey M J, Roth J A. Current management of chest-wall tumors. Surg Clin North Am. 1989; 69 1061-1080
- 8 King R M, Pairolero P C, Trastek V F, Piehler J M, Payne W S, Bernatz P E. Primary chest wall tumors: factors affecting survival. Ann Thorac Surg. 1986; 41 597-601
- 9 Widhe B, Bauer H CF. Scandinavian Sarcoma Group . Surgical treatment is decisive for outcome in chondrosarcoma of the chest wall: a population-based Scandinavian Sarcoma Group study of 106 patients. J Thorac Cardiovasc Surg. 2009; 137 610-614
- 10 Tomo H, Ito Y, Aono M, Takaoka K. Chest wall deformity associated with osteochondroma of the scapula: a case report and review of the literature. J Shoulder Elbow Surg. 2005; 14 103-106
- 11 Shackcloth M J, Page R D. Scapular osteochondroma with reactive bursitis presenting as a chest wall tumour. Eur J Cardiothorac Surg. 2000; 18 495-496
- 12 Eroglu A, Kürkçüoglu I C, Karaoglanoglu N. Solitary eosinophilic granuloma of sternum. Ann Thorac Surg. 2004; 77 329-331
- 13 Bayram A S, Köprücüoglu M, Filiz G, Gebitekin C. Case of solitary eosinophilic granuloma of the sternum. Thorac Cardiovasc Surg. 2008; 56 117-118
- 14 Biswas S, Keddington J. Soft right chest wall swelling simulating lipoma following motor vehicle accident: transdiaphragmatic intercostal hernia. A case report and review of literature. Hernia. 2008; 12 539-543
- 15 Takamori S, Miwa K, Hayashi A, Shirouzu K. Intramuscular lipoma in the chest wall. Eur J Cardiothorac Surg. 2004; 26 1038
- 16 Ozpolat B, Ozeren M, Akkaya T, Yucel E. Giant lipoma of chest wall. Eur J Cardiothorac Surg. 2004; 26 437
- 17 Eren S, Avci A. Giant cystic lymphangioma in the thoracic wall in a newborn. Asian Cardiovasc Thorac Ann. 2009; 17 659
- 18 Yildirim E, Dural K, Kaplan T, Sakinci U. Cystic lymphangioma: report of two atypical cases. Interact Cardiovasc Thorac Surg. 2004; 3 63-65
- 19 Sakurai K, Hara M, Ozawa Y, Nakagawa M, Shibamoto Y. Thoracic hemangiomas: imaging via CT, MR, and PET along with pathologic correlation. J Thorac Imaging. 2008; 23 114-120
- 20 Griffo S, Stassano P, De Luca G, Di Tommaso L, Monaco M, Spiezia S. Intramuscular hemangioma of the chest wall: an unusual tumor. J Thorac Cardiovasc Surg. 2007; 134 1368-1369
- 21 Gallo A E, Coady M A. Chest wall tumors. In: Yuh D D, Vricella L A, Baumgartner W A, eds. The Johns Hopkins Manual of Cardiothoracic Surgery. New York, NY: McGraw Hill; 2007: 75-90
- 22 Bölke E, Krasniqi H, Lammering G et al.. Chest wall and intrathoracic desmoid tumors: surgical experience and review of the literature. Eur J Med Res. 2009; 14 240-243
- 23 Abbas A E, Deschamps C, Cassivi S D et al.. Chest-wall desmoid tumors: results of surgical intervention. Ann Thorac Surg. 2004; 78 1219-1223 discussion 1219-1223
- 24 Tateishi U, Gladish G W, Kusumoto M et al.. Chest wall tumors: radiologic findings and pathologic correlation: part 2. Malignant tumors. Radiographics. 2003; 23 1491-1508 Review
- 25 Stanić V, Vulović T, Novaković M et al.. Radical resection of giant chondrosarcoma of the anterior chest wall. Vojnosanit Pregl. 2008; 65 64-68
- 26 Somers J, Faber L P. Chondroma and chondrosarcoma. Semin Thorac Cardiovasc Surg. 1999; 11 270-277
- 27 Lee W S, Kim Y H, Chee H K et al.. Multimodal treatment of primary extraskeletal Ewing's sarcoma of the chest wall: report of 2 cases. Cancer Res Treat. 2009; 41 108-112
- 28 Bousnina S, Zendah I, Marniche K et al.. Solitary plasmocytoma of the rib: a rare tumor not to miss. Rev Pneumol Clin. 2006; 62 243-246
- 29 Yoshida N, Miyanari N, Yamamoto Y, Egami H. Successful treatment of malignant fibrous histiocytoma originating in the chest wall: report of a case. Surg Today. 2006; 36 714-721
- 30 Shoji T, Sonobe M, Okubo K, Wada H, Bando T, Date H. Giant primary liposarcoma of the chest. Gen Thorac Cardiovasc Surg. 2009; 57 159-161
- 31 Styring E, Fernebro J, Jönsson P E et al.. Changing clinical presentation of angiosarcomas after breast cancer: from late tumors in edematous arms to earlier tumors on the thoracic wall. Breast Cancer Res Treat. 2010; 122 883-887
- 32 Schwarz R E, Burt M. Radiation-associated malignant tumors of the chest wall. Ann Surg Oncol. 1996; 3 387-392
- 33 Haraguchi S, Hioki M, Takushima M, Yanagimoto K, Koizumi K, Shimizu K. Metastatic chest wall tumor suspected to be of lung origin by immunoreactivity for cytokeratin 7 and 20. Jpn J Thorac Cardiovasc Surg. 2006; 54 132-136
- 34 Hazard H W, Gorla S R, Scholtens D, Kiel K, Gradishar W J, Khan S A. Surgical resection of the primary tumor, chest wall control, and survival in women with metastatic breast cancer. Cancer. 2008; 113 2011-2019
- 35 La Quaglia M P. Chest wall tumors in childhood and adolescence. Semin Pediatr Surg. 2008; 17 173-180
- 36 Wyttenbach R, Vock P, Tschäppeler H. Cross-sectional imaging with CT and/or MRI of pediatric chest tumors. Eur Radiol. 1998; 8 1040-1046
- 37 van den Berg H, van Rijn R R, Merks J HM. Management of tumors of the chest wall in childhood: a review. J Pediatr Hematol Oncol. 2008; 30 214-221
M. Blair Marshall M.D.
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Washington, DC 20008
eMail: mbm5@gunet.georgetown.edu