Medical expert of the article
New publications
Tumors of the chest wall
Last reviewed: 12.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Primary tumors of the chest wall account for 5% of all thoracic tumors and 1-2% of all primary tumors. Almost half of them are benign, the most common of which are osteochondroma, chondroma, and fibrous dysplasia. There are a number of malignant tumors of the chest wall. More than half are metastases from distant organs or direct invasions from adjacent structures (breast, lung, pleura, mediastinum). The most common malignant primary tumors developing from the chest wall are sarcomas; approximately 45% develop from soft tissue and 55% from cartilage or bone. Chondrosarcomas are the most common primary bone sarcomas of the chest wall, arising in the anterior ribs and less commonly from the sternum, scapula, or clavicle. Other bone tumors include osteosarcoma and small cell malignancies (Ewing's sarcoma, Askin's tumor). The most common primary soft tissue malignancies are fibrosarcomas (desmoids, neurofibrosarcomas) and malignant fibrous histiocytomas. Other primary tumors include chondroblastomas, osteoblastomas, melanomas, lymphomas, rhabdosarcomas, lymphangiosarcomas, multiple myeloma, and plasmacytomas.
Symptoms of Chest Wall Tumors
Soft tissue tumors of the chest wall often present as a localized mass with no other symptoms; some patients have a fever. Patients usually do not experience pain unless the tumor has spread. In contrast, primary tumors of cartilage and bone are often painful.
Diagnosis of chest wall tumors
Patients with chest wall tumors undergo chest X-rays, chest CT scans, and sometimes MRIs to determine the location and extent of the tumor and whether it is a primary chest wall tumor or a metastasis. A biopsy confirms the diagnosis.
[ Treatment of chest wall tumors
Most chest wall tumors are treated primarily with surgical resection and reconstruction. Reconstruction often involves a combination of myocutaneous flaps and artificial materials. The presence of malignant pleural effusion is a contraindication to surgical resection. In addition, in cases of multiple myeloma or isolated plasmacytoma, chemotherapy and radiation therapy should be the first-line therapy. Small cell malignancies such as Ewing sarcoma and Askin tumor should be treated with a combination of chemotherapy, radiation therapy, and surgery. In cases of metastasis to the chest wall from distant tumors, palliative chest wall resection is recommended only in cases where conservative treatments fail to relieve the symptoms of chest wall tumors.
What is the prognosis for chest wall tumors?
Chest wall tumors have variable prognoses, depending on cell type and stage; precise data are limited because of the rarity of any given tumor. Sarcomas have been the most extensively studied, and primary chest wall sarcomas have a reported five-year survival rate of 16.7%. Survival is better when the disease is detected early.