MANAGEMENT CHALLENGE IN CHEST WALL NEOPLASMS

A 2 YEAR EXPERIENCE

Abstract

Introduction: Chest wall neoplasms are rare and represent only about 5% of
all thoracic neoplasm. We present our 2 years analysis of the clinical features, presentation,
diagnosis and treatment of chest wall neoplasms. Study design: Case series study. Place and
duration of study: Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi,
Pakistan from Nov 2012- Oct 2014. Methodology: Between 2012 and 2014, 39 patients with solid
chest wall masses were enrolled in the study. Tumors were categorized as benign and malignant,
including primary and secondary, after histopathological diagnosis with tissue biopsy. Data on
patients’ characteristics, symptoms, tumor type and management was recorded and analysed.
Results: The study included 39 patients (20 males and 19 females) with age range 18-71years
(mean 36.3). 21(53.8%) patients had benign chest wall tumors while 18(46.1%) patients had
malignant tumors. Among malignant tumors, 14(77%) patients had primary malignancy where
as 4(22%) patients had chest wall tumor secondary to primary tumor elsewhere. Among these
4, the primary tumor remained unknown in 1 patient. The most common benign solid lesion
was chest wal lesion lipoma in 8/21 patients (38%). Among malignant tumors, chondrosarcoma
(4/14, 29%) was the most common. Conclusion: Preoperative needs careful assessment of the
patient, radiological imaging and histopathological examination for diagnosis of the tumor in
the chest wall. Using a multidisciplinary team approach, excellent results can be available with
complete surgical resection, reconstruction of the chest wall and appropriate or neo adjuvant
treatment where necessary.