Massive chondrosarcoma of the chest wall

[Primary and secondary chest wall tumors--diagnosis, therapy and results]

In a retrospective study 51 patients who underwent chest wall resection for malignant chest wall tumors were reviewed. There were 28 male and 23 female patients with ages ranging from 6 to 76 years (average 50). 34 patients had primary malignant neoplasms (including breast and lung) 17 had metastatic tumors. The tumor was located in the ribs in 45 patients and in the sternum in 6. Reconstruction was with prosthetic material in 16 patients and further plastic reconstruction in 10. Aggressive resection for malignant chest wall tumors and reliable reconstruction can be performed safely, and early wide resection proved to be a potentially curative treatment for primary neoplasms.

Initial and long-term results in the management of primary chest wall neoplasms

One hundred ten patients with primary chest wall neoplasms were analyzed for long-term results. The diagnosis of 59 malignant and 51 benign tumors was confirmed by the Armed Forces Institute of Pathology. No deaths were associated with primary definitive therapy. Among the five most frequently encountered malignant tumor types, five-year survivals were obtained in 9 of 17 (53%) patients with fibrosarcoma, 8 of 9 (89%) patients with chondrosarcoma, 2 of 8 (25%) patients with solitary chest wall plasmacytoma (multiple myeloma), 1 of 6 (17%) patients with Ewing's sarcoma, and 2 of 4 (50%) of patients with osteogenic sarcoma. Although the five-year survival appears to indicate therapeutic success in patients with Ewing's sarcoma and osteogenic sarcoma, patients with chondrosarcoma or fibrosarcoma may have a more protracted course, and those with solitary plasmacytoma usually develop multiple myeloma. The findings suggest that radical surgical excision is the treatment of choice for chondrosarcoma; radical surgical excision combined with chemotherapy, for fibrosarcoma and osteogenic sarcoma; surgical excision combined with radiation and chemotherapy, for Ewing's sarcoma; and systemic surveillance and therapy, for pathologically confirmed solitary plasmacytoma.