• Journal of Chest Surgery
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• v.50 no.4
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• pp.308-311
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• 2017

A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.795-798
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• 2008

A 50 year old male patient was admitted due to fever and left upper-quadrant abdominal pain. He had a history of previous treatment for pulmonary TB and splenectomy due to plastic anemia. A large peritoneal abscess with connection to a chronic left side tuberculous empyema thoracis was diagnosed on admission. Chest CT also revealed a soft issue lesion on the left anterior chest wall. Staged drainage of the peritoneal lesion followed by left side pleuropneumonectomy with chest wall resection was performed. The pathologic studies showed a high grade sarcoma of the chest wall.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.175-181
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• 2003

Primary chest wall tumors originate from soft tissue, bone or cartilage of the chest wall and it comprises 1∼2% of all primary tumors. Resection of tumor is often indicated for chronic ulceration or pain, and long-term survival might be achieved after surgery depending on the histology and the surgical procedure. Material and Method: Retrospective study of 125 primary chest wall tumors (86 benign, 39 malignant) operated between Sep. 1976 to Mar 2001 were reviewed and their clinical outcomes were analyzed. Follow-up data were collected at the outpatient clinic. Result: All patients with benign tumors were treated by excision without recurrence or death, and most malignancies were treated by wide resection. Malignant fibrous histiocytoma and chondrosarcoma constituted 46.2% of the malignant neoplasm. There was no operative death. The overall 3-year survival for patients with primary malignant neoplasm was 76.0%, and the 10-year survival was 60.5%. All deaths were disease-related and the tumor recurred in 11 patients. There was no significant difference in survival between patients with resection margins less than 4 cm and those with resection margins greater than 4 cm. Conclusion: Chest wall resection offers excellent results for benign chest wall tumors and substantial long-term survival for malignant diseases. Safe resection margin of 4 cm or more did not correlate with the survival rate although the tumor recurrence correlated with poor survival.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.399-403
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• 1999

Background: Funnel chest is one of the most common anomaly of chest wall, which is manifested by depression of sternum and costal cartilage. Popular operative methods were Ravitch operation and Wada operation. Material and Method: From 1983 to 1996, 21 cases of funnel chest were corrected surgically in the department of thoracic surgery, National Medical Center. Investigated age and sex distribution, combined anomaly,clinical symptom, degree of correction and complication, postoperative satisfaction. We used 2 different surgical methods, one was Wada & its variants(17 cases), the other was Ravitch and it variants(4 cases). Most of operative indications were cosmetic problems. Result: The pre-operative Welch index was 4.188, but this index decreased to 3.46 after the operations.(p=0.046) The degree of correction was higher in Wada & it variant operation than the modified Ravitch operation.(p=0.54) Their results were satisfactory in 20 patients, while unsatisfactory in 1 patient because of a k-wire fracture. There was no recurrence of chest wall depression or postoperative death during the OPD follow up period. Conclusion: We recommend Wada operation in symmetric and small degree of depressive chest wall deformity in preand post school age.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.808-814
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• 2010

Purpose: The sunken chest deformity without breast asymmetry is not a rare condition encountered in augmentation mammaplasty. Therefore, failure to recognize the deformity and improper surgical plan will lead to a suboptimal result. The authors review the experience of breast augmentation in simple sunken chest patient based on retrospectively collected data. Methods: From January, 2008 to January, 2009, patients with simple sunken chest underwent endoscopic submuscular augmentation mammaplasty through axilla, using silicone implants. Patient demographics were queried and outcomes were assessed. Results: Eleven patients (22 breasts) were followed up for 8.2 months after surgery. Sunken chests were augmented with implant size of approximately 248.9 cc (range: 213~286 cc) and contralateral chest with 211.4 cc (range: 180~235 cc). Simultaneous camouflaging the chest wall depression with breast augmentation resulted in good aesthetic outcome. All of the patients were satisfied with the surgery. There were no complications among all patients. Conclusion: We have demonstrated proper surgical planning with precise implant selection to optimize results in patients with small breast and simple sunken chest. Even though asymmetry still remains after the operation, it is still considered as acceptable.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.307-311
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• 1979

Bronchogenic carcinoma with subcutaneous metastasis is rare, and the incidence ranged from 1.0 to 3.0 %. Therefore metastatic nodules are incidental findings in some instances. The distribution in order of frequency Is as follows: chest wall, scapular region, abdominal wall, course of spine, upper extremities and scalp etc, and mos. of nodules are between 0.5-2.0 cm in diameter. In this report, we present one case of a 54 year old male having bronchogenic carcinoma (squamous cell type) with multiple subcutaneous metastases. The metastatic nodules were located in subcutaneous tissue of right posterior chest wall ($4{\times}5$ cm), frontal scalp area (two; $2{\times}3$ cm, $0.5{\times}0.5$ cm), left scapular region ($1{\times}1$ cm) and left iliac crest ara ($1{\times}11$ cm).

• Journal of Chest Surgery
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• v.33 no.10
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• pp.834-838
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• 2000

Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.

• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.57-60
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• 2019

Warthin's tumor (WT) is second most common neoplasm in the parotid gland and it can be accompanied by inflammation and necrosis. The chest wall inflammation may present a rapid and fatal clinical course and secondary to parotid abscess is extremely rare. An 81-year-old man came to emergency room complained of rapidly enlarged left parotid mass and inflammatory symptoms and signs around the upper lateral neck. We performed incision and drainage with adequate infection control. He was pathologically diagnosed as abscess. We report the unique and instructive clinical case with a literature review.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.390-394
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• 2018

Background: The nonsurgical treatment of chest wall deformity by a vacuum bell or external brace is gradual, with correction taking place over months. Monitoring the progress of nonsurgical treatment of chest wall deformity has relied on the ancient methods of measuring the depth of the excavatum and the protrusion of the carinatum. Patients, who are often adolescent, may become discouraged and abandon treatment. Methods: Optical scanning was utilized before and after the intervention to assess the effectiveness of treatment. The device measured the change in chest shape at each visit. In this pilot study, patients were included if they were willing to undergo scanning before and after treatment. Both surgical and nonsurgical treatment results were assessed. Results: Scanning was successful in 7 patients. Optical scanning allowed a visually clear, precise assessment of treatment, whether by operation, vacuum bell (for pectus excavatum), or external compression brace (for pectus carinatum). Millimeter-scale differences were identified and presented graphically to patients and families. Conclusion: Optical scanning with the digital subtraction of images obtained months apart allows a comparison of chest shape before and after treatment. For nonsurgical, gradual methods, this allows the patient to more easily appreciate progress. We speculate that this will increase adherence to these methods in adolescent patients.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.790-792
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• 2010

A 77-year-old man presented with a huge protruding mass on the left anterior chest wall. The tumor was resected and diagnosed as dermatofibrosarcoma protuberans (DFSP). DFSP is an uncommon, intermediate-grade mesenchymal cutaneous tumor which extends deep into subcutaneous tissue and may invade through the fascial planes and into muscle but rarely metastasize. Histologically, DFSP is composed of spindle cells arranged in an irregularly whorled or storiform pattern. The histological diagnosis can be confirmed with immunohistochemical staining for CD34. We report a case of DFSP. The tumor was completely excised and the chest wall was reconstructed using latissimus dorsi muscle flap and skin graft.