Primary chest wall neoplasms—resection and reconstruction

Abstract

Background

Primary chest wall tumours are rare. We report our experience of primary chest wall neoplasms, their resection and reconstruction treated at our centre.

Methods

We reviewed a prospectively collected data from August 2013 to December 2014. Data included the mode of clinical presentation, imaging, biopsy, type of surgical resection and reconstruction, complications, morbidity and mortality. Recurrences if any and survival outcomes were recorded.

Results

A total of 14 patients were reviewed (M/F ratio was 9:5) with a median age of 35.5 years. Palpable mass (78.5 %) was a common presenting symptom. All patients underwent surgical resection, and reconstruction was required in 11 patients (78.5 %), with bone cement, mesh or greater omentum. Overall, 35.7 % (5 out of 14) received neoadjuvant therapy for downstaging and 14.2 % (2 out of 14) received adjuvant radiotherapy for positive margins. Early post-operative complications were seen in eight patients (57.1 %), and there was no in-hospital mortality. Factors that effected survival were resection margins and type of pathology.

Conclusion

Primary chest wall neoplasms need surgical resection. Multidisciplinary approach is necessary. The extent of tumour resection should not be compromised because of concerns over the ability to reconstruct large and complex defects. Prosthetic reconstruction is a safe and effective surgical procedure for major chest wall defects.