Wednesday, July 11, 2007

Chest Wall Tumors

Primary chest wall tumors consist of 5% of all thoracic tumors and 1 to 2% of all primary tumors. Almost 12 are benign, the most common of which are osteochondroma, chondroma, and fibrous dysplasia. A wide range of malignant chest wall tumors exist. Over 12 are metastases from distant organs or direct invasions from adjacent structures (breast, lung, pleura, mediastinum). The most common malignant primary tumors arising from the chest wall are sarcomas; about 45% originate from soft tissue and 55% from cartilaginous or bony tissue. Chondrosarcomas are the most common primary bone chest wall sarcoma and arise in the anterior tract of ribs and less commonly from the sternum, scapula, or clavicle. Other bony tumors include osteosarcoma and small-cell malignant tumors (Ewing's sarcoma, Askin's tumor). The most common soft-tissue primary malignant tumors are fibrosarcomas (desmoids, neurofibrosarcomas) and malignant fibrous histiocytomas. Other primary tumors include chondroblastomas, osteoblastomas, melanomas, lymphomas, rhabdomyosarcomas, lymphangiosarcomas, multiple myeloma, and plasmacytomas.

Symptoms, Signs, and Diagnosis

Soft-tissue chest wall tumors often present as a localized mass without other symptoms; some patients have fever. Patients usually do not experience pain until the tumor is more advanced. In contrast, primary cartilaginous and bone tumors are often painful.

Patients with chest wall tumors require chest x-ray, CT, and sometimes an MRI to determine the original site and extent of the tumor and whether it is a primary chest wall tumor or a metastasis. Biopsy confirms the diagnosis.

1 comment:

Anonymous said...

Well written article.