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INCIDENCE
BASIC PRINCUPLES
Signs and Symptoms
1. Chest wall tumors grow slowly.
2. Most patients have no symptoms initially.
3. Pain may occurs in nearly all malignant
tumors and 2/3 of benign tumors.
4. Fever, leukocytosis and eosinophilia may
accompany some chest wall tumors
Diagnosis
History, PE and lab exams
Chest plain film and CT scan
MRI can distinguish tumor from vessels and nerves,
but does not assess lung nodules and calcification in the
lung.
Chest wall tumors must be diagnosed with incisional
biopsy( tumor> 5 cm ) or excisional( tumor 3 5 cm )
biopsy.
Needle aspiration biopsy should be only for patients
with a known primary tumor elsewhere.
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Treatment(1)
Wide resection is essential for malignant
chest wall tumors.
The margin of normal tissue is 4 cm.
For tumors of rib cage, involved ribs, partial
ribs above and below the tumor must be
removed.
Treatment(2)
For tumors of the sternum, manubrium, resection
of the involved bone and corresponding costal
arches is indicated.
Any attached structures, such as lung, thymus,
chest wall muscle or pericardium must be
removed.
The role of resection of chest wall metastasis and
recurrent breast cancer is controversial
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SPECIFIC TUMORS
A. Primary Bone Tumors
* Primary bone neoplasms involving chest wall
are uncommon.
* The most common benign bone tumors are
cartilaginous in origin-osteochondroma and
chondroma.
* The most common malignant bone tumors are
myeloma, chondrosarcoma, malignant
lymphoma and Ewings sarcoma.
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SPECIFIC TUMORS
B. Primary Soft Tissue Tumors
B-1 Benign Soft Tumors
* Predominant tumors are fibroma,
lipoma, giant cell tumors, vascular
tumors and neurogenic tumors.
* Malignant degeneration is uncommon.
* Local excision is the choice.
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