• Journal of Chest Surgery
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• 제47권4호
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• pp.427-430
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• 2014

Chondrosarcoma of the chest wall is a rare primary neoplasm found to occur in elderly men. Patients present with an enlarging, painful, anterior chest wall mass arising from either the vicinity of the costochondral junction or the sternum. Treatment includes wide resection with appropriate chest wall reconstruction. We report an unusual presentation of this uncommon tumor occurring as a huge chest wall mass in a young teenage girl.

• Journal of Chest Surgery
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• 제28권8호
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• pp.778-783
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• 1995

The incidence of chest wall tumor is rare than those of other portions of the body. The chest wall tumors need special attention about their diagnosis and management than other tumors. From March, 1985 to September, 1994, 33 patients with chest wall tumor underwent surgical treatment, and those were consisted of 28 benign tumors and 5 malignant tumors arising from soft tissue, rib and sternum.Benign tumors were included 11 lipoma, 4 cysticercosis, 2 chondroma and 1 each of fibroma, dermatofibroma, osteochondroma, fibrous dysplasia and hemangioma,and 6 other cases. Malignant chest wall tumors were included 2 metastatic carcinoma,1 each of giant cell tumor, chondrosarcoma and epithelioid sarcoma.Sex ratio of male to female was 1.5:1, and the range of age was 16 to 72 years,and the mean age was about 40 years. Clinical manifestations of chest wall tumor were palpable mass[55% , pain[21% ,tender mass[9% , growing mass[9% and asymptomatic[9% .The all cases were treated surgically, the results were as follows:Local excision 16 cases, wide resection 12 cases, wide resection with chemotherapy 3 cases, each one case of wide resection with radiotherapy and wide resection with chest wall reconstruction.

• Journal of Chest Surgery
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• 제51권5호
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• pp.308-311
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• 2018

We herein present a new surgical reconstruction technique for large chest wall defects after resection of advanced chest wall tumors.

• Journal of Chest Surgery
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• 제24권6호
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• pp.547-554
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• 1991

From May 1965 to December 1990, 78 patients with chest wall tumors were operated on. The mean age of the patients was 31.5 years with 50 male and 28 female patients. Forty-nine cases[62.8%] were developed at bony or cartilaginous wall and 29 cases[37.2%] at soft tissue of chest wall. Thirty-two of them[41.0%] were malignant, either primary or metastatic, and 46 tumors[59.0%] were histologically benign. For 55 patients who were operated on since 1982, 6 surgical biopsies. 39 tumor excisions, and 11 wide excisions with chest wall reconstruction were done. Preoperative factors favoring diagnosis of malignant neoplasm were; 1] old-aged male patient, 2] bone or cartilaginous tumors, 3] involvement of multiple ribs, 4] complaint of pain, 5] large size on palpation[larger than 4cm]. With proper diagnosis and management plan, we think, operations of chest wall tumors can give good results.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.277-280
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• 2010

Purpose: The resection of locally advanced or recurred breast cancers frequently result in large chest wall defects and it leads to a great challenges to cover. Generally simple skin grafts are not a practical option for patients because of their poor cosmetic appearance and prognosis. The latissimus dorsi and rectus abdominis musculocutaneous flap have traditionally been recommended for closure of these large defects. Though the cosmetic result of reconstruction using these flaps is often excellent, but has significant drawbacks. Therefore, we thought that chest wall reconstruction using the external oblique musculocutaneous flap can be an alternative method for extensive chest wall defect related to large, locally advanced breast carcinoma. Methods & Results: We present a case of a 50-year-old Korean female, refered to our department with a left breast tumor for 10 months. CT demonstrate a large tumor on the left anterior chest wall and multiple nodules of varying size in the cervical areas and liver. FDG-PET showed areas of hot uptake throughout the left chest wall, mediastinum and liver. Biopsy was consistent with invasive ductal carcinoma (Grade III). The initial tumor was considered inoperable, so a series of chemotherapy was initiated. Though the size of the breast mass was slightly decreased, the patient continued to suffer from purulent discharge, unpleasant odor and contact bleeding of the mass, the salvage mastectomy was performed. Conclusion: We could reconstruct $23{\times}16\;cm$ sized large chest wall defect, resulting from the resection of a locally advanced breast carcinoma, using an external oblique musculocutaneous flap successfully. Immediate postoperatively checked flap was healthy. Overall result was good without any significant complications and discharged 3 weeks after operation.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.409-414
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• 2010

Purpose: Poland's syndrome encompasses a constellation of congenital chest wall, breast, and upper extremity deformities. We would like to present several techniques, which may be combined if necessary, used to treat the forms involving both the breast and chest wall according to the degree of deformity. Methods: In a retrospective series of 9 patients (3 men and 6 women), we report our experience with reconstructing breast and chest contour deformities associated with Poland syndrome. We recorded their age, gender, the surgical techniques, and the grade in Poland's syndrome according to the classification of Foucras. Results: The breast and chest wall deformities associated with Poland syndrome can be treated in individualized fashion according to the classification of Foucras. In case of 3 male patients with gradeI, II, the latissimus dorsi muscle pedicled flap improved the chest contour deformity. 3 female patients with grade II underwent the latissimus dorsi muscle pedicled flap with breast implant. 2 female patients with gradeIunderwent breast reconstruction with breast implant and fat injection each other. One female patient with severe chest wall deformity (grade III) underwent breast reconstruction using the free TRAM flap. All patients were satisfied with the results without specific complications. Conclusion: The Individualized correction for this syndrome according to the degree of patient's deformity and preference made the overall satisfaction of the patients high.

• Journal of Chest Surgery
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• 제7권1호
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• pp.61-66
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• 1974

Primary tumors of the chest wall are rare than those of other portions of the body. Soft tissue tumors of the chest wall, though these are benign or malignant, should not be paid special attentions about their management than other soft tissue tumors of the body. Thoracic skeletal tumors, however, have some problems in the treatment because of defect in chest wall leading to herniation of lung and paradoxical movement of thoracic cage. The authors experienced 10 case of primary chest wall tumors at the department of thoracic and cardiovascular surgery, the national medical center, during last 15 years. Five of 10 cases were soft tissue tumors, and they were 2 case of lipoma and each one case of myxosarcoma and leiomyosarcoma. Among 5 bone tumors there no cases of sternal tumor, and their histopathological diagnosis were each one of fibrous dysplasia, giant cell tumor, osteochondroma, Ewing`s sarcoma and osteogenic sarcoma. Wide excision, though it was palliative one in certain case, was performed in 9 cases and only diagnostic incisional biopsy in one case, There were no postoperative deaths during admission to the hospital and all cases were missed during short term follow up after discharge from the hospital.

• Journal of Chest Surgery
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• 제52권1호
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• pp.36-39
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• 2019

Primary malignant fibrous histiocytoma (MFH) of the chest wall is extremely rare and is characterized by aggressive features, including a high incidence of local recurrence and distant metastasis. Surgical resection of the chest wall is the primary modality of management. However, surgical treatment is not generally recommended in patients with evidence of distant metastasis. Here, we present a case of chest wall MFH along with a schwannoma mimicking distant metastasis in the right upper arm. The patient was treated by radical en bloc resection and survived for more than 9 years without recurrence.

• Journal of Chest Surgery
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• 제34권12호
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• pp.924-929
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• 2001

배경 : 흉벽을 침습한 비소세포암의 외과적 절제후의 장기 생존율에는 현재까지 림프절 전이, 완전 절제, 흉벽침습 깊이 등이 관여한다고 알려져 있다. 본 연구에서는 완전절제후의 예후에 관련된 요소들에 대해 알아보고자 한다. 대상 및 방법 : 1988년부터 1998년까지 원발성 비소세포암으로 수술을 받은 680명중, 벽측늑막과 흉벽을 침범한 경우에 완전절제를 실시한 55예(8.0%)에 대해 후향적 방법을 통해 분석하였다. 결과 : 29예(47.3%)에서 총괄절제를 시행하고 26예(52.7%)에서 늑막외절제를 실시하였다. 늑막외절제를 시행한 모든 예에서 침습정도는 벽측늑막에 국한되어 있었고, 총괄절제군에서는 9예(31.0%)에서 벽측늑막에 나머지 20예(69.0%)에서는 흉벽에의 침습이 병리학적으로 판명되었다. 수술사망은 3명에서 발생해 5.4%였으며, 추적은 100%에서 가능하였다. 전체환자군의 5년 생존율은 26%였으며, T3N0M0군의 생존율이 29%로 T3N2M0군의 18% 보다 높기는 하나 통계학적인 유의성은 없었다.(p=0.35) 흉벽침습 깊이정도에 따른 생존율은 림프절 전이의 유무에 관련없이 유의한 차이가 없었다.(p=0.99) 결론 : 흉벽을 침습한 T3 비소세포암에 대해 완전절제를 실시해 만족할 만한 생존율을 보였다. 림프절 전이 여부는 완전절제후의 생존율에 관여하는 바가 크나, 침습 깊이는 관여하는 정도가 덜하다.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.39-42
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• 2022

Bilateral pectoralis major myocutaneous (PMMC) flaps are commonly used to reconstruct large chest wall defects. We report a case of large chest wall defect reconstruction using bilateral PMMC flaps augmented with axillary V-Y advancement rotation flaps for additional flap advancement. A 74-year-old male patient was operated on for recurrent glottic squamous cell carcinoma. Excision of the tumor resulted in a 10×10 cm defect in the anterior chest wall. Bilateral PMMC flaps were raised to cover the chest wall defect. For further flap advancement, V-Y rotation advancement flaps from both axillae were added to allow complete closure. All flaps survived completely, and postoperative shoulder abduction was not limited (100° on the right side and 92° on the left). Age-related skin redundancy in the axillae enabled the use of V-Y rotation advancement flaps without limitation of shoulder motion. Bilateral PMMC advancement flaps and the additional use of V-Y rotation advancement flaps from both axillae may be a useful reconstructive option for very large chest wall defects in older patients.