Chest Wall Tumours

The chest wall refers to the structures surrounding and protecting the lungs, enclosed by the spine, and separated from the abdomen by the diaphragm. These structures include a myriad of tissues, including cartilage, bone, muscle, fascia, vasculature, lymphatic vessels, fat, and skin.

Tumors of the chest wall subdivide into two categories, primary and secondary. Primary chest wall tumors arise from muscle, fat, blood vessel, nerve sheath, cartilage, or bone of the chest wall. Secondary chest wall tumors can be from direct invasion of breast carcinoma or lung carcinoma or metastases from a distant site of origin.

The most common benign tumors are osteochondromas and chrondromas. The most common malignant chest wall tumors are sarcomas.

Symptoms

The most common symptoms of chest wall cancer are:

• Chest pain
• Swelling in the chest
• A mass or lump protruding from the chest
• Muscle atrophy
• Impaired movement

Sometimes chest wall cancer does not exhibit any symptoms. About 20 percent are found incidentally on chest X-rays.

Diagnosis

The process of diagnosing a chest wall tumor typically begins with a physical exam, followed by an imaging test, such as an X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI). If we need additional information, we may do a biopsy. This involves taking a tissue sample from the tumor and testing it in the lab.

Treatment

Treatment options will depend upon the type of chest wall tumor found. If the tumor is benign, no treatment may be required, although at times, proving that a chest wall tumor is benign requires that it be removed (excisional biopsy).

The treatment of a malignant chest wall tumor may involve chemotherapy, radiation, or surgery, or a combination of all three. A portion of the rib cage must frequently be removed to eradicate a chest wall tumor; very effective reconstruction (replacement) of the chest wall using adjacent muscle, mesh or mesh with “plastic” material is available. The amount of chest wall that must be removed, the proposed method of reconstruction, and associated risks and benefits of the operation are reviewed by the surgeon with the patient prior to scheduling the procedure.

Our centre has a vast experience in managing such tumours with excellent results.

Chest Wall Tumour requiring surgical management