Chest Wall Tumor

Chest Wall Tumor - Chest Wall Tumors 1 Table 45-1...

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1 Chest Wall Tumors
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2 Table 45-1 Classification of Chest Wall Tumors __________________________________________ Primary neoplasm of chest wall: malignant, benign Metastatic neoplasms to chest wall: sarcoma, carcinoma Adjacent neoplasms with local invasion: lung, breast, pleura Nonneoplastic disaease: cyst, inflammation __________________________________________
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3 INCIDENCE Primary chest wall tumors are uncommon. 50-80 % of these tumors are malignant. Soft tissues are major sources of chest wall tumors. The most common primary malignant chest wall tumors are malignant fibrous histiocytoma, rhabdomyosarcoma and chondrsarcoma. The most common primary benign chest wall tumors cartilaginous tumors, desmoids and fibrous dysplasia.
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4 Table 45-2 Primary chest wall tumors Malignant myeloma, malignant fibrous histiocytoma, chondrosarcoma, rhbdomyosarcoma, Ewing’s sarcoma, liposarcoma, lymphoma, leiomyosarcoma, hemangiosarcoma Benign osteochondroma, chondroma, desmoids, fibrous dysplasia, lipoma, fibroma, neurilemoma
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5 BASIC PRINCUPLES Signs and Symptoms 1. Chest wall tumors grow slowly. 2. Most patients have no symptoms initially. 3. Pain may occurs in nearly all malignant tumors and 2/3 of benign tumors. 4. Fever, leukocytosis and eosinophilia may accompany some chest wall tumors
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6 Diagnosis History, PE and lab exams Chest plain film and CT scan MRI can distinguish tumor from vessels and nerves, but does not assess lung nodules and calcification in the lung. Chest wall tumors must be diagnosed with incisional biopsy( tumor> 5 cm ) or excisional( tumor 3 –5 cm ) biopsy. Needle aspiration biopsy should be only for patients with a known primary tumor elsewhere.
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7 Treatment(1) Wide resection is essential for malignant chest wall tumors. The margin of normal tissue is 4 cm. For tumors of rib cage, involved ribs, partial ribs above and below the tumor must be removed.
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8 Treatment(2) For tumors of the sternum, manubrium, resection of the involved bone and corresponding costal arches is indicated. Any attached structures, such as lung, thymus,
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Chest Wall Tumor - Chest Wall Tumors 1 Table 45-1...

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