Chest wall tumors are benign or malignant tumors, which can interfere with lung function.
Primary chest wall tumors account for 5% of all thoracic tumors and 1-2% of all primary tumors. Almost half is benign. The most common benign chest wall tumors are
Chest wall tumors are benign or malignant tumors, which can interfere with lung function. Primary chest wall tumors account for 5% of all thoracic tumors and 1-2% of all primary tumors. Almost half is benign. The most common benign chest wall tumors are osteochondroma chondroma Fibrous dysplasia There are a wide range of malignant chest wall tumors. More than half are metastases from distant organs or direct tumor infiltration of adjacent structures (breast, lung, pleura, mediastinum). The most common malignant primary tumors, which occur in the chest wall, are sarcomas; about 45% have a connective tissue origin and 55% result from cartilage or bone tissue. Chondrosarcomas are the most common primary sarcomas of the chest wall and ribs are formed in the front portions and less frequently in sternum, clavicle or scapula. Bone tumors include osteosarcoma and small cell malignant tumors (z. B. Ewing’s sarcoma, Askin tumor). The most common primary malignant stromal are fibrosarcomas (desmoid tumors, neurofibrosarcoma) and malignant fibrous histiocytoma. Other primary tumors include Chondroblastomas, osteoblastomas, melanomas, lymphomas, rhabdomyosarcoma, Lymphangiosarkome, multiple myeloma and plasmacytoma. Symptoms and complaints connective tissue tumors often manifest themselves as local mass without further symptoms. Some patients have a fever. Patients often have no pain until the tumor progresses. In contrast, primary cartilage and bone tumors are often painful. Diagnostic Imaging techniques biopsy patients with chest wall tumors have an X-ray chest film, CT, MRI and occasionally received PET-CT to determine the original location and extent of the tumor and to distinguish whether it is a primary tumor or a metastasis. A biopsy and histologic evaluation confirm the diagnosis. Prognosis The prognosis varies depending on the type of cancer cell differentiation and stage. Secure prognostic statements are limited by the low incidence of all tumors occurring. Sarcomas were the most studied and primary Brustwandsarkome should have a 5-year survival rate of 17%. Survival is better for diseases at an early stage. Treatment Surgical procedures Sometimes combination of chemotherapy, radiation and surgical intervention Most chest wall tumors are surgically resected with subsequent reconstruction of the chest wall. The reconstruction often uses a combination of mucocutaneous flap surgery and prosthetischem material. The presence of a malignant pleural effusion is a contraindication for surgical resection. In case of multiple myeloma or an isolated plasmacytoma first-line therapy of chemotherapy and radiotherapy should be. Small cell malignant tumors such as Ewing’s sarcoma, and Askin tumor should be treated with a multimodal approach that combines the chemotherapy, radiation and surgery. In the case of chest wall metastasis from distant tumors palliative Brustwandresektion is only recommended when non-surgical measures do not relieve the symptoms. Key points Nearly half the wall breast tumors are benign. Less than half of malignant chest wall tumors are primary. Pull the diagnosis considered if patients have a mass in the chest or unexplained chest wall pain, with or without fever. Diagnose chest wall tumors with imaging, followed by a biopsy. Treat the most with a surgical resection and reconstruction (unless it is a malignant pleural effusion before) and sometimes chemotherapy and / or radiotherapy.