Cardiothoracic Surgery: Chest Wall Tumor

Tumors

• Benign Tumors:
  • Osteochondroma – Most Common Benign Tumor
    • Common at the Costochondral Junction
  • Chondroma
  • Fibrous Dysplasia
  • Eosinophilic Granuloma
  • Hemangioma
  • Neurofibroma
  • Desmoid Tumor
• Malignant Tumors:
  • Metastatic Lesions – Most Common Chest Wall Tumor Overall
  • Chondrosarcoma – Most Common Primary Malignant Tumor
  • Osteosarcoma
  • Ewing Sarcoma
  • Plasmacytoma
  • Soft Tissue Sarcoma

Presentation

• Chest Mass
• Chest Pain – Usually Indicates Malignancy (Possible Nerve Invasion)
• Pathologic Fractures
• 20% Asymptomatic & Discovered Incidentally

Diagnosis

• Imaging: CT or MRI
• Tissue Biopsy:
  • Small (< 3 cm) & Favorable Location (Away from Vital Structures): Excisional Biopsy
  • Large (≥ 3 cm) or Critical Location (Near Great Vessels): Core Needle Biopsy

Surgical Resection

• Goal Margins: Wide Excision with ≥ 4 cm
• May Require Chest Wall Reconstruction (Mesh & Muscle Flaps)