Tumors of the chest wall
Last reviewed: 23.04.2024
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Primary tumors of the thoracic wall account for 5% of all tumors of the chest and 1-2% of all primary tumors. Almost half of the cases are benign tumors, the most common of which are osteochondrosis, chondroma and fibrotic 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 (mammary gland, lung, pleura, mediastinum). The most common malignant primary tumors developing from the chest wall are sarcomas; approximately 45% develop from soft tissues and 55% of cartilage or bone tissue. Chondrosarcomas are the most frequent primary bone sarcomas of the thoracic wall, appear in the anterior segments of the ribs and less often from the sternum, scapula or clavicle. Other bone tumors include osteogenic sarcoma and small cell malignant tumors (Ewing's sarcoma, Askin's tumor). The most frequent primary malignant tumors of soft tissues are fibrosarcomas (desmoids, neurofibrosarcomas) and malignant fibrotic histiocytomas. Other primary tumors include chondroblastomas, osteoblasts, melanomas, lymphomas, rhabdomyosarcomas, lymphangiosarcomas, multiple myeloma and plasmacytomas.
Symptoms of breast wall tumors
Soft-tissue breast wall tumors often represent a limited formation without other symptoms; in some patients, the temperature rises. Patients usually do not experience pain until the tumor spreads. In contrast, primary tumors from the cartilage and bone tissue are often painful.
Diagnosis of breast wall tumors
Patients with tumors of the chest wall carry out chest X-ray, computed tomography of the chest and sometimes NMR, which allows to determine the place of formation and prevalence of the tumor, and whether this tumor is the primary tumor of the chest wall or metastasis. A biopsy confirms the diagnosis.
[Treatment of tumors of the breast wall
Most tumors of the thoracic wall are treated first of all by surgical resection and reconstruction. Reconstruction often involves the use of a combination of a musculocutaneous flap and artificial materials. The presence of malignant pleural effusion is a contraindication for surgical resection. In addition, in cases of multiple myeloma or isolated plasmacytoma, first-line therapy should be chemotherapy and radiation therapy. Small cell malignant tumors such as Ewing's sarcoma and Askin tumors should be treated in combination, using chemotherapy, radiotherapy, and surgery. When metastasizing to the chest wall from distant tumors, pallial resection of the thoracic wall is recommended only in cases where conservative treatment methods do not alleviate the symptoms of breast wall tumors.
What prognosis are the tumors of the chest wall?
Tumors of the chest wall have a different prognosis; it depends on the type of cells and stage; accurate information is limited due to the rarity of any given tumor. Sarcomas were most well studied, and primary breast sarcoma of the thoracic wall, according to available data, a five-year survival rate of 16.7%. Survival is better when the disease is detected in the early stages.