Malignant soft tissue tumors of chest wall

Malignant soft tissue tumors of chest wall - Malignant soft...

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Unformatted text preview: Malignant soft tissue tumors Malignant soft tissue tumors of chest wall of chest wall CS morning meeting CS morning meeting Fibrous: Desmoid, fibrosarcoma Fibrohistiocyte: Malignant fibrous histiocytoma Adipose: Liposarcoma Nerve: Neurofibrosarcoma , Schwann cell sarcoma Muscle: Rhadomyosarcoma Male> Female 2:1 Rhadomyosarcoma most prevalent in children and young adult Liposarcoma : 50-60y/o female+ s/s Usually non_painful mass Pain 10% ; High dose R/T can induce soft tissue sarcoma after 5-10 years Finding on CXr: bone invasion, metastasis to lung and intrthoracic involved Prognostic indicators Tumor grade distal metastasis and margin Low grade: 5 years survival 80-90% High grade: 40-50 % after complete resection Histopathology did not influence survival (NCI) Some report: muscle type worse than fibrous type Tumor size and age: not had been found to influence survival Pseudocapsule: OFTEN CONTAIN MICROSCOPIC DISEASE: ; CONTACT THIS PSEUDOCAPSULE MUST BE AVOID DURING RESECTION CAN SPREADE ALONG BLOOD VESSELS NERVE SHEAT AND FASCIAL PLANE MFH: can spreade into the marrow; so the affected rib or portion of the rib above and below need to be resectd MFH: spindle cell with round pleomorphic nucleoli arrange in a cartwheel pattern Can be radiation induce Wide excision Positive margin: + R/T C/T is usually ineffective 5 years survival 35% Rhadomyosarcoma: Wide excision R/T + C/T 5 years survival : 70% Liposarcoma Low grade Wide excision Local recurrence repeat resection R/T is not particularly effective 5 years survival: 80% Hight grade more easy metastaiss than lower grade 51: 10% R/T may decrease the necessity for radical surgical procedure Adj C/T for high grade tumor is controversial Long term f/u is required to detect local recurrence and possible metastatic disease to lungs Margin of soft tissue sarcoma Margin of soft tissue sarcoma Cs morning meeting 2007 Dec Cs morning meeting 2007 Dec...
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Malignant soft tissue tumors of chest wall - Malignant soft...

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