scholarly journals Chondrosarcoma of the anterior chest wall : surgical resection and reconstruction using a two layer polypropylene mesh and bone cement sandwich

2015 ◽  
Vol 05 (04) ◽  
pp. 102-104
Author(s):  
Amol Amonkar ◽  
Mundayat Gopalakrishnan ◽  
AmithKiran Naik ◽  
Vishwanath S. ◽  
Saquib Sultan ◽  
...  
Keyword(s):  
Bone Cement ◽  
Chest Wall ◽  
Polypropylene Mesh ◽  
Costal Cartilage ◽  
Surgical Excision ◽  
Large Mass ◽  
Anterior Chest Wall ◽  
Current Therapy ◽  
Malignant Tumours ◽  
The Right

AbstractPrimary malignant tumours of the chest wall are uncommon. Chondrosarcoma is the most common malignancy among them, the current therapy for chondrosarcoma requires adequate surgical excision. A 50 year old male presented with a swelling on the anterior chest wall, trucut biopsy of the swelling was reported as chondrosarcoma. Thorax computed tomography (CT) revealed a large mass nd lesion with the epicentre at the costal cartilage of the right 2 rib extending beyond the chest wall and musculature and protruding internally upto the upper lobe of the right lung, features likely of chondrosarcoma.Inorder to obtain disease free surgical margins, an enst nd rd bloc resection of the tumour along with approximately 4 cms of 1 riband 2 and 3 rib and reconstruction of the anterior chest wall was performed with a 2 layer polypropylene mesh and bone cement sandwich. The post-operative course was uneventful.The chest wall reconstruction with the two layer polypropylene mesh and bone cement provided the essential rigidity and stability to the chest wall.

scholarly journals Intrascrotal lipoblastoma in adulthood

2019 ◽  
Vol 12 (12) ◽  
pp. e231320
Author(s):  
Mário José Pereira-Lourenço ◽  
Duarte Vieira-Brito ◽  
João Pedro Peralta ◽  
Noémia Castelo-Branco
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
S100 Protein ◽  
Surgical Excision ◽  
Large Mass ◽  
Histological Diagnosis ◽  
Physical Exam ◽  
Nodular Lesion ◽  
Inferior Portion ◽  
The Right

This case report describes the case of a 37-year-old man that noticed an intrascrotal right mass with 1 month of evolution. During physical exam presented with a large mass at the inferior portion of the right testicle, clearly separated from the testicle, with a tender consistency and mobile. An ultrasound was performed that showed a solid and subcutaneous nodular lesion, extra testicular, heterogeneous, measuring 7.2 cm. Pelvic magnetic resonance imageMRI showed a lesion compatible with a lipoma. The patient was subjected to surgical excision of the lesion by scrotal access, having histology revealed a lipoblastoma (LB) of the scrotum. Histological diagnosis was obtained by microscopic characteristics (well-circumscribed fatty neoplasm) and immunohistochemistry (stains for CD34, S100 protein and PLAG1 were positive; stains for MDM2 and CDK4 were negative). LB is extremely rare after adolescence in any location, being this first described case of intrascrotal LB described in adulthood.

scholarly journals Resection of primary cardiac angiosarcoma infiltrating the right atrioventricular junction and tricuspid valve: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lubna Bakr ◽  
Hussam AlKhalaf ◽  
Ahmad Takriti
Keyword(s):  
Surgical Resection ◽  
Tricuspid Valve ◽  
Right Atrium ◽  
Large Mass ◽  
Small Mass ◽  
Malignant Tumours ◽  
Atrioventricular Junction ◽  
Cardiac Angiosarcoma ◽  
Complete Surgical Resection ◽  
The Right

Abstract Background Primary cardiac tumours are extremely rare. Most of them are benign. Sarcomas account for 95% of the malignant tumours. Prognosis of primary cardiac angiosarcoma remains poor. Complete surgical resection is oftentimes hampered when there is extensive tumour involvement into important cardiac apparatus. We report a case of cardiac angiosarcoma of the right atrium and ventricle, infiltrating the right atrioventricular junction and tricuspid valve. Case presentation Initially, a 22-year-old man presented with dyspnoea. One year later, he had recurrent pericardial effusion. Afterwards, echocardiography revealed a large mass in the right atrium, expanding from the roof of the right atrium to the tricuspid valve. The mass was causing compression on the tricuspid valve, and another mass was seen in the right ventricle. Complete resection of the tumour was impossible. The mass was resected with the biggest possible margins. The right atrium was reconstructed using heterologous pericardium. The patient’s postoperative course was uneventful. Postoperative echocardiography showed a small mass remaining in the right side of the heart. Histopathology and immunohistochemistry confirmed the diagnosis of angiosarcoma. The patient underwent adjuvant chemotherapy and radiotherapy later on. He survived for 1 year and 5 days after the surgery. After a diagnosis of lung and brain metastases, he ended up on mechanical ventilation for 48 h and died. Conclusions Surgical resection combined with postoperative chemotherapy and radiotherapy is feasible even in patients with an advanced stage of cardiac angiosarcoma when it is impossible to perform complete surgical resection.

1150 A Painless Anterior Chest Wall Mass Post Coronary Artery Bypass Grafting Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Reid ◽  
F Alakhras Aljanadi ◽  
R Beattie ◽  
A Graham
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Chest Wall ◽  
Artery Bypass ◽  
Costal Cartilage ◽  
Bypass Graft ◽  
Anterior Chest Wall ◽  
Chronic Obstructive ◽  
Wall Mass ◽  
Chest Wall Mass

Abstract Aim We aim to present here a case of a painless anterior chest wall mass which was first noted during routine follow up post coronary artery bypass graft surgery Case presentation An 80-year-old male developed an asymptomatic slow growing pronounced swelling over the right anterior chest wall post CABG. His other past medical history includes chronic obstructive pulmonary disease, pulmonary fibrosis, ischaemic heart disease, an AICD for complete heart block, hypertension, hyperlipidaemia and osteoarthritis. A CT scan demonstrated a 10 x 12 x 6.5 cm subcutaneous lesion at the mid-line of the lower chest wall adjacent to the xiphisternum and the previous sternotomy site. On clinical examination there was a large non-tender cystic swelling with peripheral calcifications, but overlying skin was normal. Fluid was aspirated from the lesion and cytology showed a paucicellular specimen with features in keeping with seroma. Due to the progressive increase in size patient underwent surgical resection. A gelatinous bloody fluid was aspirated from the lesion and it was then resected enbloc. The tumour base appeared to arise from 6/7th costal cartilage and tumour was shaved away. The mass was confirmed histologically to be chondrosarcoma. Conclusions Given the uncommon prevalence of malignant primary chest wall tumours this case highlights the importance of high clinical suspicion even after developing post CABG.

Mediastinal tracheostomy: unilateral resection of the anterior chest wall

2005 ◽  
Vol 119 (11) ◽  
pp. 903-905 ◽  
Author(s):  
T Lequeux ◽  
G Chantrain ◽  
M P Thill ◽  
S Saussez
Keyword(s):  
Chest Wall ◽  
Median Sternotomy ◽  
Anterior Chest Wall ◽  
Tracheal Resection ◽  
Medial Part ◽  
New Techniques ◽  
Muscular Flap ◽  
The Right ◽  
Gastric Pull Up ◽  
Mediastinal Tracheostomy

Since the first reliable mediastinal tracheostomy described by Grillo et al. in 1966, many new techniques have been described in order to reduce the number of complications. We here report the case of a 55-year-old man who was referred for surgery with post-radiochemotherapy recurrence of a double neoplasm of the pharyngolarynx extending to the proximal trachea and the medial part of the oesophagus. Through a median sternotomy, a pharyngolaryngoesophagectomy was performed with an extended tracheal resection. The reconstruction of the upper digestive tract was performed with a gastric pull-up. The mediastinal tracheostomy was performed with a pectoralis major muscular flap through a right unilateral resection of the manubrium, the right clavicular head and the right first and second costal cartilages. Historically, the mediastinal tracheostomy was performed through a large bilateral resection of the anterior chest wall, in order to prevent the tension on the tracheocutaneous sutures. Nowadays, with the possibility of various pedicled flaps, bilateral resection no longer seems to be necessary. This unilateral resection leads to a reduction in post-operative sequelae.

scholarly journals Anterior Chest Wall Involvement in Early Stages of Spondyloarthritis: Advanced Diagnostic Tools

2012 ◽  
Vol 39 (9) ◽  
pp. 1844-1849 ◽  
Author(s):  
ROBERTA RAMONDA ◽  
MARIAGRAZIA LORENZIN ◽  
ALESSANDRO LO NIGRO ◽  
STEFANIA VIO ◽  
PIETRO ZUCCHETTA ◽  
...  
Keyword(s):  
Chest Wall ◽  
Bone Scan ◽  
High Sensitivity ◽  
Anterior Chest Wall ◽  
Diagnostic Tools ◽  
Bone Edema ◽  
Rheumatology Unit ◽  
Bone Scans ◽  
Therapeutic Decision Making ◽  
The Right

Objective.Anterior chest wall (ACW) involvement is difficult to evaluate in patients with spondyloarthritis (SpA). Bone scan is sensitive to ACW involvement, while magnetic resonance imaging (MRI) detects early alterations in SpA. We compared the sensitivity and specificity of bone scans and MRI in assessing ACW in early SpA.Methods.Out of 110 patients with early SpA attending the Outpatient Rheumatology Unit Clinic of Padua University from January 2008 to December 2010, the 40 complaining of pain and/or tenderness [60% with psoriatic arthritis (PsA), 12.5% with ankylosing spondylitis, and 27.5% with undifferentiated SpA] underwent bone scans and MRI.Results.At clinical examination, sternocostoclavicular joints were involved in 87.5% on the right, 77.5% on the left, and 35% on the sternum. Bone scan was positive in 100% and MRI in 62.5% of these patients. Early MRI signs (bone edema, synovial hyperemia) were observed in 27.5%, swelling in 5%, capsular structure thickness in 37.5%, erosions in 15%, bone irregularities in 15%, osteoproductive processes in 12.5%, and osteophytes in 5%. A higher prevalence of Cw6, Cw7, B35, and B38 was found in 15%, 48%, 28%, and 12%, respectively, of the patients with PsA who had bone scans.Conclusion.Noted mainly in women, ACW involvement was frequent in early SpA. Both bone scans and MRI are useful in investigating ACW inflammation. Bone scans were found to have high sensitivity in revealing subclinical involvement, but a low specificity. MRI provides useful information for therapeutic decision making because it reveals the type and extent of the process. The significant associations of HLA-Cw6 and Cw7 with PsA could suggest that genetic factors influence ACW involvement.

scholarly journals TẠO HÌNH XƯƠNG ỨC VÀ THÀNH NGỰC BẰNG NẸP VÍT TRONG VẾT THƯƠNG NGỰC XUYÊN

2020 ◽  
Vol 1 ◽  
pp. 56-59
Author(s):  
Dr. Hoang Quoc Toan ◽  
Dr. Hoang Anh Tuan
Keyword(s):  
Chest Wall ◽  
Vital Signs ◽  
Anterior Chest Wall ◽  
Complex Problem ◽  
Breath Sounds ◽  
Mediastinal Infection ◽  
Chest Wound ◽  
Close Range ◽  
Pectoralis Muscles ◽  
The Right

chest wall was destroyed in the penetrating chest wound is dificult problems for a variety of conditions and has been a complex problem in the past due to intraoperative technical difficulties, surgical complications, and respiratory failure. The surgical technique of chest wall stabilization for fail chest and reconstruction with a screws plate as a part of destroyed chest wall and reconstruction is described here in this article.Cas reporte A 54-year-old male was shot in the left thorax , fired from a AK bullet at close range (plus than 3 m). He arrived to our hopital approximately 8 hours after the injury. He had absent breath sounds on the left side, rapid respiratory rate 35 L/P,upper anterior fail chets(paradoxical motion of segments of the chest wall) and his vital signs were stable (pulse was 130, blood pressure was 140/90 mmHg. Physical examination revealed a single skin laceration (plus than 2. cm) with less surrounding contusion at the left anterier-axillary line; 3th intercostal space. The admission chest radiograph revealed a all left hemothorax(pleural effusion). chest X-ray demonstrated a foreign body at the right clavicle bone with the form of an bulett (Figure 1). A leftsided thoracostomy tube drained blood, the patient underwent a traumatic thoracotomie.the bullet and ribs,1/2 anterior upper sternum, muscles on the destroyed anterior upper chest wall were removed.wide anterior chest wall defects on only shaped by steel wires and screws plate and grand pectoralis muscles to the chest wall fix (stabilisation), avoid reversal respiratory and mediastinal infection.. The patient had an uneventful hospital stay and was discharged home 25 days later.

scholarly journals Outcome of Keloid's Treatment in a Tertiary Care Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 6-8
Author(s):  
Binod Karn ◽  
S. M. Mishra
Keyword(s):  
Chest Wall ◽  
Recurrence Rate ◽  
Surgical Excision ◽  
Anterior Chest Wall ◽  
Care Hospital ◽  
Complete Excision ◽  
Tension Free ◽  
Triamcinolone Injection ◽  
Group A ◽  
Group B

Introduction: Keloids are characterized by their continued growth following trauma, extension into normal tissue and their high recurrence rate following excision. Keloids are common following ear piercing or flame burns. These lesions are highly conspicuous and cosmetically unappealing. Multiple methods including surgery, radiotherapy, antimitotic agents, silicone sheet, pressure clipsand cryotherapy have been advocated. The risk of recurrence and the need to prevent distortion of following resection is a challenge to the surgeon. Material and Methods: A total of 46 patients with keloid were treated at the plastic surgery department of the Nepalgunj Medical College between January 2013 to March 2017. The patients were divided in two groups. Group A consisted of 24patients with keloid in their ear where complete excision of keloid was done with tension free repair and was supplemented withintralesion triamcinolone injection at the time of operation and thereafter as and when needed. Group B consisted of 22 patients. Out of these 15 patients had keloid over the anterior chest wall and rest 07 had keloid over the deltoid region. These cases receivedintralesional triamcinolone only, a total of 5 such injections at month interval as a tension free repair after excision was notconsidered feasible. Results & Conclusion: Patients in Group A underwent surgical excision and intra and post operative intralesionalsteroids and patients in Group B received 4 weekly intraregional injection of triamcinolone injection 40 mg. Out of 24 keloid in Group A two developed post-excision recurrence during a mean follow-up period of 24 months. However they regressed with subsequent local injection of steroid. The group B consisting of scar over the deltoid region and anterior chest wall were not found suitable for excision as a tension free repair (a must to prevent recurrence) was not considered possible. Complete Excision of keloids with tension free suture and local steroid injection is a simple & favored technique for the management of keloid, it preserves contour &skin quality and has a low recurrence rate. Unfortunately all cases are not suitable for total surgical excision. In such cases, steroid locally has to given locally at monthly intervals. The keloids regresses, but atrophy and depigmentation at the site of injection are the complications.

scholarly journals Rectus sternalis muscle - a rare anatomical variant

2013 ◽  
Vol 02 (01) ◽  
pp. 41-43
Author(s):  
Veena Vidya Shankar ◽  
Rahe Rajan ◽  
Komala Nanjundaiah ◽  
Sheshgiri Chowdapurkar
Keyword(s):  
Chest Wall ◽  
Surgical Procedures ◽  
Anterior Chest Wall ◽  
Breast Mass ◽  
Anatomical Variant ◽  
Medial Side ◽  
Male Cadaver ◽  
The Right ◽  
Sternalis Muscle ◽  
Diagnostic Investigations

AbstractThe Rectus Sternalis muscle is an unusual muscle that is observed on the anterior chest wall. The origin of this muscle is a highly debated variation of the pectoral musculature. We report a case of an abnormal vertically placed muscle - The rectus sternalis muscle, on the right medial side of the anterior chest wall of a male cadaver aged about 80 years. The abnormal presence of this muscle can be misdiagnosed as a breast mass on a routine mammogram. The advantage is its role in reconstruction flap surgeries. Hence knowledge of such an anatomical variant should be kept in mind during diagnostic investigations and surgical procedures.

Giant diffuse neurofibroma of the chest wall involving the sternum: challenging chest wall reconstruction

2020 ◽  
pp. 021849232098148
Author(s):  
Sachin Mahajan ◽  
Vivek Jaswal ◽  
Vidur Bansal ◽  
Aravind Sekar ◽  
Vikas Kumar
Keyword(s):  
Head And Neck ◽  
Chest Wall ◽  
Skin Graft ◽  
Polypropylene Mesh ◽  
Anterior Chest Wall ◽  
Full Thickness ◽  
Split Skin Graft ◽  
Rare Form ◽  
Tumor Mass ◽  
Split Skin

Diffuse neurofibroma is a rare form of neurofibroma, usually reported in the head and neck. To our knowledge, diffuse neurofibroma of the anterior chest wall has not been reported previously. Even rarer is involvement of the sternum in neurofibroma. We report a case of a 30-year-old lady who presented with a rapidly growing, painless giant exophytic mass involving almost the entire anterior chest wall. The tumor mass was infiltrating the sternum. Excision of the tumor left a large full-thickness thoracic defect that was covered using polypropylene mesh beneath a pedicled omental flap with a split skin graft over it.

scholarly journals Chest wall pseudotumor: a case of non-tuberculous mycobacterial infection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yutaka Shishido ◽  
Hiroshi Hamakawa ◽  
Kazuhiro Minami ◽  
Shigeo Hara ◽  
Yutaka Takahashi
Keyword(s):  
Chest Wall ◽  
Tumor Resection ◽  
Public Health Problem ◽  
Surgical Excision ◽  
Mycobacterial Infection ◽  
Epithelioid Cell ◽  
Thoracic Wall ◽  
Chest Wall Tumor ◽  
En Bloc ◽  
The Right

Abstract Background Non-tuberculous mycobacterial (NTM) infections are increasing worldwide, making them an international public health problem. Surgical management is often indicated for localized infectious disease; however, most surgeons are unaware of the potential risks of transmission during surgery. Case presentation An 88-year-old Asian female was referred to our hospital for a tumor in the right lateral thoracic region. One month prior, she had a feeling of fullness and complained of localized pain and warmth in the right lateral thoracic wall. Pain and warmth gradually resolved without intervention; however, the fullness was getting worse. Computed tomography (CT) scan showed a mass of approximately 65 × 30 mm with an osteolytic change, involving the right 8th rib. Based on the rapid growth rate and CT findings, we strongly suspected a malignant chest wall tumor, and en bloc tumor resection with the 8th rib was performed. When the specimen was cut, a large amount of viscous pus was drained and its culture showed growth of Mycobacterium avium. Microscopically, the non-caseating epithelioid cell granuloma extended into the rib, infiltrating the bone cortex. On follow-up 1 month after discharge, there were no signs of infection or other adverse events associated with the surgery. Conclusions Herein, we report about a patient with a mass diagnosed as an NTM abscess involving the rib cage, which was confused with a malignant tumor and eventually diagnosed following surgical excision. This report emphasizes the need to be aware of the possibility of NTM infection and take appropriate precautions if the patient has a rapidly growing mass in the chest wall.

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