Skip to main content
SpringerLink
Log in

Mini review: surgical management of primary chest wall tumors

  • Review Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Primary chest wall tumors (PCWTs) are relatively rare entities, and their clinical characteristics as well as appropriate treatments are not fully known. Previously reported studies, including ours, are reviewed here, taking into account the clinical approach and findings in Japan for the diagnosis, distribution of histological types, surgical procedures, and prognosis of these entities. Surgery for PCWTs comprised that approximately 0.7 % of surgeries in 2012 in Japan and 28.3 % of PCWTs were malignant with an extremely low rate of mortality within 30 days from surgery. Surgical biopsy is recommended for the differential diagnosis of chest wall tumors to determine if they are primary, metastatic, benign, or malignant lesions. Of the 297 PCWT cases reported in nine published studies, neurogenic tumors were the most common benign PCWT, and chondrosarcoma was the most common malignant PCWT. Reconstruction of the resected chest wall was performed for 41.3 % of cases, and the materials used were e-PTFE or polypropylene. The prognosis of patients with benign tumors is usually good if complete resection is achieved; however, the 5-year recurrence rate and disease-related mortality were approximately 22.5 and 18.1 %, respectively, for patients with malignant tumors. Surgery for PCWTs is safe; however, surgical treatment for patients with malignant PCWTs remains challenging, and multimodal treatments for each histological tumor type should be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. 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 Surg. 2001;19:589–93.

    Article  CAS  PubMed  Google Scholar 

  2. David EA, Marshall MB. Review of chest wall tumors: a diagnostic, therapeutic, and reconstructive challenge. Semin Plast Surg. 2011;25:16–24.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Threlkel JB, Adkins RB Jr. Primary chest wall tumors. Ann Thorac Surg. 1971;11:450–9.

    Article  CAS  PubMed  Google Scholar 

  4. Sakata R, Fujii Y, Kuwano H. Thoracic and cardiovascular surgery in Japan during 2009: annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2011;59:636–67.

    Article  PubMed  Google Scholar 

  5. Kuwano H, Amano J, Yokomise H. Thoracic and cardiovascular surgery in Japan during 2010: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2012;60:680–708.

    Article  PubMed  Google Scholar 

  6. Amano J, Kuwano H, Yokomise H. Thoracic and cardiovascular surgery in Japan during 2011: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2013;61:578–607.

    Article  PubMed  Google Scholar 

  7. Masuda M, Kuwano H, Okumura M, Amano J, Arai H, Endo S, et al. Thoracic and cardiovascular surgery in Japan during 2012: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2014;62:734–64.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Sabanathan S, Shah R, Mearns AJ. Surgical treatment of primary malignant chest wall tumours. Eur J Cardiothorac Surg. 1997;11:1011–6.

    Article  CAS  PubMed  Google Scholar 

  9. Hsu PK, Hsu HS, Lee HC, Hsieh CC, Wu YC, Wang LS, et al. Management of primary chest wall tumors: 14 years’ clinical experience. J Chin Med Assoc. 2006;69:377–82.

    Article  PubMed  Google Scholar 

  10. Mankin HJ, Lange TA, Spanier SS. The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J Bone Joint Surg Am. 1982;64:1121–7.

    Article  CAS  PubMed  Google Scholar 

  11. Ryan MB, McMurtrey MJ, Roth JA. Current management of chest-wall tumors. Surg Clin N Am. 1989;69:1061–80.

    Article  CAS  PubMed  Google Scholar 

  12. Anderson BO, Burt ME. Chest wall neoplasms and their management. Ann Thorac Surg. 1994;58:1774–81.

    Article  CAS  PubMed  Google Scholar 

  13. Kawashima O, Kakegawa S, Nagashima T, Ibe T, Nakano T, Shimizu K. Current surgical treatment of primary chest wall tumor. Kyobu Geka. 2014;67:9–14 (in Japanese).

    PubMed  Google Scholar 

  14. Tsushima T, Kowatari R, Kimura D, Sakai T, Hatanaka R, Yamada Y, et al. Results of non-rigid prosthetic reconstruction with expanded polytetrafluoro-ethylene(ePTFE) soft tissue patch following chest wall resection for malignant tumors. Kyobu Geka. 2014;67:49–53 (in Japanese).

    PubMed  Google Scholar 

  15. Shah AA, D’Amico TA. Primary chest wall tumors. J Am Coll Surg. 2010;210:360–6.

    Article  PubMed  Google Scholar 

  16. Tateishi U, Gladish GW, Kusumoto M, Hasegawa T, Yokoyama R, Tsuchiya R, et al. Chest wall tumors: radiologic findings and pathologic correlation: part 2. Malignant tumors. Radiographics. 2003;23:1491–508.

    Article  PubMed  Google Scholar 

  17. Dimopoulos MA, Moulopoulos LA, Maniatis A, Alexanian R. Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Blood. 2000;96:2037–44.

    CAS  PubMed  Google Scholar 

  18. Jackson A, Scarffe JH. Prognostic significance of osteopenia and immunoparesis at presentation in patients with solitary myeloma of bone. Eur J Cancer. 1990;26:363–71.

    Article  CAS  PubMed  Google Scholar 

  19. Incarbone M, Pastorino U. Surgical treatment of chest wall tumors. World J Surg. 2001;25:218–30.

    Article  CAS  PubMed  Google Scholar 

  20. Maeda S, Yamada T, Watanabe T, Niikawa H, Sado T, Noda M, et al. Contribution of surgical margin for surgical outcome of the chest wall tumors. Kyobu Geka. 2014;67:15–20 (in Japanese).

    PubMed  Google Scholar 

  21. Widhe B, Bauer HC. Surgical treatment is decisive for outcome in chondrosarcoma of the chest wall: a population-based Scandinavian Sarcoma Group study of 106 patients. J Thorac Cardiovasc Surg. 2009;137:610–4.

    Article  PubMed  Google Scholar 

  22. Novais EN, Demiralp B, Alderete J, Larson MC, Rose PS, Sim FH. Do surgical margin and local recurrence influence survival in soft tissue sarcomas? Clin Orthop Relat Res. 2010;468:3003–11.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kawaguchi N, Ahmed AR, Matsumoto S, Manabe J, Matsushita Y. The concept of curative margin in surgery for bone and soft tissue sarcoma. Clin Orthop Relat Res. 2004;419:165–72.

    Article  Google Scholar 

  24. Suzuki H, Yun T, Morimoto J, Nakajima T, Tagawa T, Iwata T, et al. Surgical treatment of primary chest wall tumor. Kyobu Geka. 2014;67:21–6 (in Japanese).

    PubMed  Google Scholar 

  25. Pairolero PC, Arnold PG. Chest wall tumors. Experience with 100 consecutive patients. J Thorac Cardiovasc Surg. 1985;90:367–72.

    CAS  PubMed  Google Scholar 

  26. King RM, Pairolero PC, Trastek VF, Piehler JM, Payne WS, Bernatz PE. Primary chest wall tumors: factors affecting survival. Ann Thorac Surg. 1986;41:597–601.

    Article  CAS  PubMed  Google Scholar 

  27. Graeber GM, Jones DR, Pairolero PC. Neoplasms of the chest wall. Pearson’s thoracic and esophageal surgery. In: Patterson GA, Cooper JD, Deslauriers J et al., editors. Philadelphia: Churchill Livingstone; 2008. p. 1291–302.

  28. Suzuki H, Sekine Y, Yamamoto N, Hiroshima K. Hemilaminectomy for a dumbbell-shaped vertebral hemangioma. Thorac Cardiovasc Surg. 2011;59:383–4.

    Article  CAS  PubMed  Google Scholar 

  29. Yun T, Suzuki H, Tagawa T, Iwata T, Mizobuchi T, Yoshida S, et al. Cavernous hemangioma of the posterior mediastinum with bony invasion. Gen Thorac Cardiovasc Surg. 2016;64:43–6.

  30. D’Alessandro P, Carey-Smith R, Wood D. Large resection and reconstruction of primary parietal thoracic sarcoma: a multidisciplinary approach on 11 patients at minimum 2-years follow-up. Orthop Traumatol Surg Res. 2011;97:73–8.

    Article  PubMed  Google Scholar 

  31. Arnold PG, Pairolero PC. Chest-wall reconstruction: an account of 500 consecutive patients. Plast Reconstr Surg. 1996;98:804–10.

    Article  CAS  PubMed  Google Scholar 

  32. Berthet JP, Wihlm JM, Canaud L, Joyeux F, Cosma C, Hireche K, et al. The combination of polytetrafluoroethylene mesh and titanium rib implants: an innovative process for reconstructing large full thickness chest wall defects. Eur J Cardiothorac Surg. 2012;42:444–53.

    Article  PubMed  Google Scholar 

  33. Togashi K, Yamato Y, Kitahara T. Resection of chest wall tumors. Kyobu Geka. 2014;67:27–30 (in Japanese).

    PubMed  Google Scholar 

  34. Bagheri R, Haghi SZ, Kalantari MR, Sharifian Attar A, Salehi M, Tabari A, et al. Primary malignant chest wall tumors: analysis of 40 patients. J Cardiothorac Surg. 2014;9:106.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Gelderblom H, Hogendoorn PC, Dijkstra SD, van Rijswijk CS, Krol AD, Taminiau AH, et al. The clinical approach towards chondrosarcoma. Oncologist. 2008;13:320–9.

    Article  PubMed  Google Scholar 

  36. Weber DM. Solitary bone and extramedullary plasmacytoma. Hematol Am Soc Hematol Educ Program. 2005;1:373–6.

    Google Scholar 

  37. Abbas AE, Deschamps C, Cassivi SD, Nichols FC, Allen MS, Schleck CD, et al. Chest-wall desmoid tumors: results of surgical intervention. Ann Thorac Surg. 2004;78:1219–23 (discussion 23).

    Article  PubMed  Google Scholar 

  38. Bolke E, Krasniqi H, Lammering G, Engers R, Matuschek C, Gripp S, et al. Chest wall and intrathoracic desmoid tumors: surgical experience and review of the literature. Eur J Med Res. 2009;14:240–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Smith MA, Seibel NL, Altekruse SF, Ries LA, Melbert DL, O’Leary M, et al. Outcomes for children and adolescents with cancer: challenges for the twenty-first century. J Clin Oncol. 2010;28:2625–34.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Biswas B, Agarwala S, Shukla NK, Deo S, Sharma D, Thulkar S, et al. Evaluation of outcome and prognostic factors in thoracic primitive neuroectodermal tumor: a study of 84 cases. Ann Thorac Surg. 2013;96:2006–14.

    Article  PubMed  Google Scholar 

  41. Shamberger RC, Laquaglia MP, Krailo MD, Miser JS, Pritchard DJ, Gebhardt MC, et al. Ewing sarcoma of the rib: results of an intergroup study with analysis of outcome by timing of resection. J Thorac Cardiovasc Surg. 2000;119:1154–61.

    Article  CAS  PubMed  Google Scholar 

  42. Yun T, Suzuki H, Mizobuchi T, Sakairi Y, Nagato K, Nakajima T, et al. Late recurrence of a tumor of Ewing’s sarcoma family of tumors: report of a case. Surg Case Rep. 2015;1:37.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Takamasa Ito, Hidemi Suzuki & Ichiro Yoshino

Authors
  1. Takamasa Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hidemi Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ichiro Yoshino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takamasa Ito.

Ethics declarations

Conflict of interest

The authors have declared that no conflict of interest exists.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ito, T., Suzuki, H. & Yoshino, I. Mini review: surgical management of primary chest wall tumors. Gen Thorac Cardiovasc Surg 64, 707–714 (2016). https://doi.org/10.1007/s11748-016-0719-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-016-0719-z

Keywords

Search

Navigation