• Journal of Chest Surgery
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• v.37 no.9
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• pp.809-812
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• 2004

Chest wall metastases from malignant tumors are rare and the majority of them are from adjacent structures such as the breast, lung, pleura, and mediastinum. Paticularly, chest wall metastases from distant organs are an even rarer event. There are few reports of chest wall metastasis with obscure or absent primary tumor. A 51-year-old man was diagnosed with metastatic hepatocellular carcinoma after an operation for a palpable mass on his left upper chest wall, At that time, there was no evidence of primary hepatocellular carcinoma in the liver after various examinations. We report a case of chest wall metastasis from unknown primary hepatocellular carcinoma.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.629-633
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• 1998

Implantation of malignant cells along the needle aspiration tract is an extremely rare potential complication following a percutaneous fine needle aspiration biopsy of a lung carcinoma. The dissemination of malignant cells by a needle aspiration biopsy may convert an operable and potentially curable lesion into a fatal disease. We report two cases of chest wall implantation of carcinoma of the lung after a thin needle aspiration biopsy. A fifty-five year old male was successfully treated by a radical full-thickness excision of the chest wall and immediate reconstruction with the latissimus dorsi musculocutaneous island flap. A sixty-eight year old female was treated with a partial-thickness excision of the chest wall and skin graft due to superimposed infection and ulceration of the metastatic chest wall carcinoma. One case lived for 31 months up to November 1994, and the other's condtion has been uneventful for 3 months up to now.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.764-767
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• 2002

An unusual case of primary leiomyosarcoma at the left lower posterior chest wall with metastasis to the right lung parenchyme is presented. The patient was a 43-year-old man who was asymptomatic but a slow growing hard mass was noted at the left lower posterior chest wall. The chest computed tomography showed a tumor at the left lower posterior chest wall with multiple metastasis to the right lung. The left lower posterior chest wall mass was examined by percutaneous needle aspiration and it was revealed as rhabdomyosarcoma histologically. En bloc resection to the left lower posterior chest wall tumor and metastasectomy to the multiple nodules in the right lung were done and pathological examination finally revealed primary leiomyosarcoma at the left lower posterior chest wall with multiple metastasis to the right lung. Chemotherapy was scheduled as adjunctive measure.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.445-448
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• 1997

Percutaneous transthoracic fine needle biopsy has been widely used In the diagnosis of pulmonary lesions especially lung cancer. Onc of the rarest complication's is that malignant cells are implanted within the needle tract and developed a chest wall mass subsequently. Wc expcrlenccd a case of chest wall implantatio of lung cancer after percutaneous transthoracic floe needle biopsy. A 65-ycar old man had undergone bilobectomy (right upper lobe and right middle lobe)for squamous cell (·4rcinoma (TINOMO) of the lung. 60 days after percutaneous biopsy (48 days after operation), a tiny nodule (1 mm sized) was notcd at the right anterior chcst wall where the diagnostic fine needle biopsy had been performed before operation. This tiny mass was rapidly growing to 1.5 cm sized mass for 20 days. We carried out wide excision of chest wall mass and skin grafting, and confirmed squamous cell carcinoma histopathologically as same as the lung cancer.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.924-929
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• 2001

Backgroun : The long-term survival after operation of patients with lung cancer invading the chest wall is known to be related to regional nodal involvement, completeness of resection and depth of chest wall involvement. In this study results of complete resection are reviewed to determine survival charateristics. Material and Method: Of 680 consecutive patients who were operated on for primary non-small cell carcinoma between 1988 and 1998, we retrospectively reviewed 55 patients(8.0%) who had complete resection for lung cancer invading the chest wall or parietal pleura. Result: Resection of the chest wall was on bloc in 29 patients(47.3％), and extrapleural in 26(52.7％). In the patients undergoing extrapleural resection, the depth of chest wall invasion was confined to the parietal pleura in all patients(100%). In the patients underging en bloc resection, the pathologic depth of invasion was into the parietal pleura alone in 9(31.0%) and into the chest wall in 20(69.0%). The follow-up rate of these patients was 100%. Hospital mortality was 5.4%(n=3). The actuarial 5-year survival rate was 26% for all hospital survivors(n=52). The actuarial 5-year survival rate of patients with T3N0M0 disease(29%) was better than that of T3N2M0 disease(18%), however, there was no significant(p=0.30) difference. The depth of chest wall invasion had no statistically significant effect on survival in our series, neither for patients with involved lymphatic metastasis nor for those without(p=0.99). Conclusion: These observations indicate that the good five year survival in patients with T3 NSCLC invading the chest wall resulted from complete resection. Survival of patients with lung cancer invading the chest wall after complete resection is dependent on the extent of nodal involvement and much less so on the depth of chest wall invasion.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.458-460
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• 1996

Percutaneous transthoracic fine needle biopsy is a popular technique in the diagnosis ot'pulmonary and pleural diseases and its complication rate is very low. One of the rarest but potential complications is that of implantation of malignant cells along the needle tract and subsequent development of a chest wall mass . We experienced a case of chest wall implantation of lung cancer after percutaneous transthoracic fine needle biopsy. The patient was a 59 year old female who had undergone right upper lobectomy for squamous cell carcinoma of the lung (T,N,Mo). 6 months after operation, a loculated mass was palpated at the right posterior .chest wall where the percutaneous transthoracic fine needle biopsy had been performed before operation. We carried out wide excision of this mass and confirmed squamous cell carcinoma histopathologically.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.472-476
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• 1996

Malignant flrous histiocytoma is a rare deep-seated pleomorphlc sarcoma, although its incidence Increasing. In this report, we present a case of a malignant fibrous histiocytoma, arising in the left chest wall in a 37-year-ol4 male patient. He underwent radical on bloc resection which include excision of tumor on left upper chest wall with resection of ribs from the first to third, left upper lo ectomy and chest wall reconstruction with Marled Mesh. However, he had local recurrence and distant metastasis within 12 months of the original operation. Malignant fibrous histiocytoma is an agrressive disease entity, with a propensity for early and distant spread.

• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.526-528
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• 2007

A giant cell tumor of bone is a benign bone tumor, but has very high local recurrence rate and, very rarely metastasizes to the lung or a distant area. We report a case of a 29-year-old male patient presenting with a metastatic giant cell tumor of the soft tissue of the chest wall, who underwent a total resection of the radius for recurrence of the giant cell tumor. The tumor was not related to any bony structure of the thorax. We resected the tumor with a wide surgical margin. No evidence of malignancy was seen in the frozen and permanent pathological report.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.239-243
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• 1996

Chest wall reconstruction Is difficult because of the physiological and anatomical functions of thoracic cavity where the thoracic cavity must be stabilized in order to prevent paradoxical motion, and adequate protection must be provided to the mediastinal structures. A 37-year-old male patient with full-thickness defect on the left anterior thoracic cavity due to traffic accident was treated. Emergency operation was performed for debridement and bleeding control, and on postoperative 25 days, chest wall reconstruction was performed as a second-stage operation. Left anterior chest wall was reconstructed with latissimus dorsi myocutaneous flap which had thoracodorsal arterial pedicle, and split-thickness skin grift from the left thigh was done. After chest wall reconstruction, spontaneous self-respiration was possible without ventilatory support. The pulmonary function test performed at postoperative 3 months revealed 80% of predicted values (FVC, FEV1.0). The postoperative result of chest wall reconstruction using latissimus dorsi myocutaneous flap was excellent anatomically, physiologically and aesthetically.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.855-857
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• 1999

Lymphangioma(or cystic hygroma) of the chest wall is rare case. We experienced one such case in a 16-year-old girl who complained of a large recurrent mass on her right upper post erolateral chest wall which had developed several years ago. The diagnosis was made following a physical examination, chest magnetic resonance imaging(MRI), and radio isotope (RI) lymphangiogrphy and was confirmed by a histopathological examination. We performed total excision of the lesion followed by a repeated sclerosing therapy with intralesional injection of Vibramycin.