Journal of the Chinese Medical Association
Volume 69, Issue 8 , Pages 377-382, August 2006

Management of Primary Chest Wall Tumors: 14 Years' Clinical Experience

  • Po-Kuei Hsu

      Affiliations

    • Division of Thoracic Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Hui-Chen Lee

      Affiliations

    • Division of Experimental Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Han-Shui Hsu, Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Chih-Cheng Hsieh

      Affiliations

    • Division of Thoracic Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Yu-Chung Wu

      Affiliations

    • Division of Thoracic Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Liang-Shun Wang

      Affiliations

    • Division of Thoracic Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Biing-Shiun Huang

      Affiliations

    • Division of Thoracic Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Wen-Hu Hsu

      Affiliations

    • Division of Thoracic Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Min-Hsiung Huang

      Affiliations

    • Division of Thoracic Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 29 September 2005; accepted 13 June 2006.

Article Outline

Background

Primary chest wall tumor is rare but it encompasses tumors of various origins. We analyzed our experience with primary chest wall tumors with emphasis on its demographic presentation and management.

Methods

From 1991 to 2004, 62 patients with the diagnosis of primary chest wall tumors were enrolled. Lipoma, chest wall metastasis, direct invasion from nearby malignancy, infection, and inflammation of chest wall were excluded. The clinical features, management, and the outcome of these patients were retrospectively reviewed.

Results

There were 37 males and 25 females. Malignant and benign tumors were equally distributed. Chondrosarcoma and lymphoma were the 2 most common types of malignant chest wall tumors. The most common clinical symptoms were palpable mass (54.8%) and pain (40.3%). Nine of 31 patients (29.0%) with benign chest wall tumors were free of symptoms whereas patients with malignant chest wall tumors were all symptomatic (p = 0.002). A definite diagnosis was obtained in 21 of 26 patients (80.7%) who received nonexcision biopsy. All patients with primary chest wall tumors, except 6 who had medical treatment only, underwent surgical resection. Patients with malignant chest wall tumors were older than those with benign tumors (p < 0.001). The mean largest diameter of tumors was also larger in malignant tumors than in benign tumors (p = 0.04).

Conclusion

Patients with primary malignant chest wall neoplasm were older than those with benign tumors. The mean size of malignant tumors was larger than that of benign tumors. Adequate surgical resection remains the treatment of choice for patients with primary chest wall tumors. Nonexcision biopsy should be reserved for patients with a past history of malignancy, suspicion of hematologic disease, and with high operative risk. For patients with isolated chest wall lym-phoma, surgical resection followed by chemotherapy can be considered to obtain a better outcome.

Key Words:  chest wall tumor , metastatic chest wall tumor

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PII: S1726-4901(09)70276-X

doi:10.1016/S1726-4901(09)70276-X

Journal of the Chinese Medical Association
Volume 69, Issue 8 , Pages 377-382, August 2006

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