Primary benign chest wall tumors: results of surgical treatment

Rigoberto Dolores-Velázquez; Carlos Daniel Lever-Rosas; Jose Luis Barrera-Franco; Alejandro Padilla-Rosciano; Mauricio Frías-Mendívil; Luis Domínguez-Parra

2007, Number 6

<< Back Next >>

Cir Cir 2007; 75 (6)

Primary benign chest wall tumors: results of surgical treatment

Dolores-Velázquez R, Lever-Rosas CD, Barrera-Franco JL, Padilla-Rosciano A, Frías-Mendívil M, Domínguez-Parra L

Full text

How to cite this article

Language: Spanish
References: 21
Page: 419-424
PDF size: 104.24 Kb.

ABSTRACT

Objective: We undertook this study to describe the clinical characteristics of primary benign chest wall tumors and to evaluate the results of surgical treatment.
Methods: We included patients with primary benign chest wall tumors who underwent surgical resection at the Instituto Nacional de Cancerología from January 1990 to December 2002. All patients had histological confirmation of benign tumor. Descriptive analysis was carried out.
Results: There were 17 patients, nine women (53%), with an average age of 35.1 years (interval 16-66 years). The most frequent tumor was chondroma in seven cases (41%), followed by aponeurotic-muscle fibromatosis in five (30%) and the remaining five patients had other tumor types. All patients were subject to thoracic wall resection, including at least one rib in each patient. In three patients the sternum was resected (17.6%), the clavicle in two (11.7%), thoracic vertebrae in one (5.9%) and associated structures in four patients (23.5%). In eight patients (47%) the thoracic wall was reconstructed with marlex mesh, whereas the remaining patients required no reconstruction. Of the 17 patients, 16 are alive without disease and one presented delayed recurrence with an aponeurotic-muscle fibromatosis requiring a new thoracic wall resection. One patient presented with respiratory complications and died after 42 days due to thoracic wall instability. Average follow-up time was 103 months.
Conclusions: Primary benign chest wall tumors are locally aggressive and must be treated with wide resection of the thoracic wall. In addition, surgical reconstruction with prosthetic materials and/or myocutaneous flaps is done prior to resection, for stability of the thorax when the localization is anterior or lateral.

REFERENCES

Incarbone M, Pastorino U. Surgical treatment of chest wall tumors. World J Surg 2001;25:218-230.
2. Sabanathan S, Salama F, Morgan E, Harvey JA. Primary chest wall tumors. Ann Thorac Surg 1985;39:4-15.
3. AlaKulju K, Ketonen P, Jarvinen A, Salo J, Luosto R. Primary tumors of the ribs. Scand J Thorac Cardiovasc Surg 1988;22:97-100.
4. Andrianopoulos EG, Lautidis G, Kormas P, Karameris A, Lahanis S, Papachristos I, et al. Tumors of the ribs: experience with 47 cases. Eur J Cardiothoracic Surg 1999;15:615-620.
5. Brodsky JT, Gordon MS, Hajdu SI, Burt M. Desmoid tumors of the chest wall. A locally recurrent problem. J Thorac Cardiovasc Surg 1992;104:900-903.
6. Allen PJ, Shriver CD. Desmoid tumors of the chest wall. Semin Thorac Cardiovasc Surg 1999;11:264-269.
7. Kabiri EH, Al Aziz S, El Masiout A, Benosman A. Desmoid tumors of the chest wall. Eur J Cardiothorac Surg 2001;19:580-583.
8. Graeber GM, Snyder RJ, Flemming AW, Head HD, Lough FC, Parker JS, et al. Initial and long-term results in the management of primary chest wall neoplasms. Ann Thorac Surg 1982;34:664-670.
9. Athanassiadi K, Kalavrouziotis G, Rondogianni D, Loutsidis A, Hatzimichalis A, Bellenis I. Primary chest wall tumors: early and long-term results of surgical treatment. Eur J Cardiothorac Sur 2001;19:589-593.
10. Ryan MB, McMurtrey MJ, Roth JA. Current management of chest wall tumors. Surg Clin North Am 1989;69:1061-1079.
11. Morgan RF, Edgerton MT, Wanebo HJ, Daniel TM, Spotnitz WD, Kron IL. Reconstruction of full thickness chest wall defects. Ann Surg 1988;207:707-716.
12. McCormack PM. Use of prosthetic materials in chest-wall reconstruction. Surg Clin North Am 1989;69:965-976.
13. Arnold PG, Pairolero PC. Chest-wall reconstruction: an account of 500 consecutive patients. Plast Reconstr Surg 1996;98:804-810.
14. Incarbone M, Nava M, Lequaglie C, Ravasi G, Pastorino U. Sternal resection for primary or secondary tumors. J Thorac Cardiovasc Surg 1997;114:93-99.
15. Eng J, Sabanathan S, Pradhan GN. Primary sternal tumors. Scand J Thorac Cardiovasc Surg 1989;23:289-292.
16. Ayala AG, Zornosa J. Primary bone tumors: percutaneous needle biopsy. Radiology 1983;149:675-670.
17. Somers J, Faber LP. Chondroma and chondrosarcoma. Semin Thorac Cardiovasc Surg 1999;11:270-277.
18. Morisaki Y, Takagi K, Ishii Y, Furuya T, Ishikawa M, Tanaka S. Periosteal chondroma developing in a rib at the side of a chest wall wound from a previous thoracotomy: report of a case. Surg Today 1996;26:57-59.
19. Pairolero PC, Arnold PG. Chest wall tumors: experience with 100 consecutive patients. J Thorac Cardiovasc Surg 1985;90:367-372.
20. Eng J, Sabanathan S, Pradhan GN, Mearns AJ. Primary bony chest wall tumors. J R Coll Surg Edinb 1990;35:44-47.
21. Jurkiewicz MJ, Arnold PG. The omentum: an account of its use in the reconstruction of chest wall. Ann Surg 1977;185:548-554.