Chest wall and diaphragm reconstruction; a technique not well established in literature

Abstract Introduction: The treatment for most primary chest wall tumors is wide excision. After radical chest wall resection, skeletal reconstruction, when appropriate to preserve the reconstruction, is the essential element for successful management. Case presentation: We describe a case of a 27-year-old male patient who had chest wall and diaphragm reconstruction for a recurrent chest wall tumor, using a single patch of Polytetrafluoroethylene (PTFE) mesh with diaphragm implanted into the middle of the mesh. There were no operative complications. The patient received post-operative radiotherapy with good functional and cosmetic results. Conclusion: We present a novel and safe technique resulting in stable results after full-thickness multi-rib chest wall resections involving the diaphragm.

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Chest wall and diaphragm reconstruction; a technique not well established in literature – case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01577-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Riad Abdel Jalil ◽

Mohamad K. Abou Chaar ◽

Obada Al-Qudah ◽

Hanna Kakish ◽

Salam Elfar

Keyword(s):

Chest Wall ◽

Respiratory Function ◽

Clinical Course ◽

Chest Wall Tumor ◽

High Morbidity ◽

Case Presentation ◽

Operative Complications ◽

Safe Technique ◽

Neighboring Structure ◽

Wall Tumor

Abstract Introduction Regardless of its rarity, and indolent clinical course, chest wall tumor places high morbidity and burden on patients especially when invasion to a neighboring structure is found. Once detected, surgery is the cornerstone for treatment of such etiology combined with chemo-radiotherapy. In order to maintain intact respiratory function, chest wall reconstruction must be performed whenever resection is done. Herein, we present a case of chest wall tumor that necessitated three ribs and part of hemidiaphragm resection and reconstruction with optimal post-operative results. Case presentation A 27-year-old male patient who had chest wall and diaphragm reconstruction for a chest wall Ewing sarcoma, using a single patch of expanded polytetrafluoroethylene (ePTFE) mesh with diaphragm implanted into the middle of the mesh. There were no immediate nor post-operative complications. The patient received post-operative radiotherapy with good functional and cosmetic results. Conclusion We present a novel and safe technique for combined chest wall and diaphragmatic resection following excision of an invading tumor while ensuring cosmesis and functionality of the ribcage as well as the diaphragm.

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Primary chest wall neoplasms - an experience of 39 patients

Annals of King Edward Medical University ◽

10.21649/akemu.v10i1.1151 ◽

2016 ◽

Vol 10 (1) ◽

Author(s):

Muhammad Salim ◽

Aamir Bilal ◽

Muhammad Shoaib Nabi

Keyword(s):

Chest Wall ◽

Primary Closure ◽

Medical Institute ◽

Chest Wall Resection ◽

Chest Wall Tumor ◽

Respiratory Compromise ◽

Term Survival ◽

Chest Wall Tumors ◽

One Year ◽

Painless Mass

Objective: To evaluate treatment approaches, role of surgical resection and reconstruction and outcome of patients with primary chest wall tumor. Study Design A prospective observational study. Place and Duration. The study was conducted at the Department of Cardiothoracic Surgery, Postgraduate Medical Institute, Lady Reading Hospital from March 1996 to April 2000. Patient and Methods A total of 39 patients underwent resection for primary chest wall tumors. Male were 27 and female were 12. Age range was 15 years - 55 years with a mean age of 23±2 years. 75% of patients presented with a painless mass while 25% complained of pain. Twenty three were on right side, twelve were on the left side while 4 extended onto the sternum. Sizes were <3cm (7 patients), 3-5cm (24 patients), 5-10cm (6 patients) and > 10cm (2 patients). Chest radiograph in all and CT thorax was done in 20 cases. Out of 39 cases, 25 had previous biopsies attempted by other surgeons leading to ulceration and fungation in 18 cases. Chest wall resection and primary closure was done in 33 cases. In 4 cases marlex mesh alone was used while in 2 cases it was reinforced with Methyl Methacrylate. Results Mean operative time was 68 (+/-40) minutes. Postoperatively, 19 patients required ventilation. Out of these, 14 patients were extubated the same day, 3 the next day while 02 patients died despite prolonged ventilation. Post-operative flail was observed in 3 cases without respiratory compromise. Histopathology reporting were chondrosarcoma in 24, fibrosarcoma in 6 cases while the rest were not reported. Twenty one patients were followed-up for up to one year with no evidence of disease while the remaining were lost to follow up. Conclusion To conclude primary chest wall tumors can be safely managed by resection and primary closure or chest wall reconstruction and are associated with long term survival.

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Human Dirofilariasis Due to D.Repens Presenting as a Chest Wall Swelling : A Rare Case Report

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703559 ◽

2012 ◽

Vol 02 (01) ◽

pp. 51-53

Author(s):

Harish S. Permi ◽

Pretty D'Souza ◽

K.R. Bhagavan ◽

Mary Raju ◽

Pooja Sarda

Keyword(s):

Chest Wall ◽

Rare Case ◽

Histopathological Examination ◽

Chest Wall Tumor ◽

Anopheles Mosquitoes ◽

Chest Wall Tumors ◽

Rare Case Report ◽

Human Dirofilariasis ◽

Wall Tumor

AbstractPrimary Dirofilariasis is caused by a Zoonotic filarial nematode. It is transmitted to humans by Culex, Aedes, or Anopheles mosquitoes, which ingest blood-containing microfilaria from affected dogs, cats, or raccoons. Chest wall tumors are uncommon lesions that originate from blood vessels, nerves, bone, cartilage, or fat. We report a case of Human Dirofilariasis due to D. Repens occurring in the chest wall in a 32 year old male. Clinical diagnosis of benign chest wall tumor was considered and it was excised. Histopathological examination confirmed it as Dirofilaria repens. On regular follow up he is doing fine.

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Massive Chest Wall Tumor Diagnosed as Askin Tumor

CHEST Journal ◽

10.1378/chest.104.1.287 ◽

1993 ◽

Vol 104 (1) ◽

pp. 287-288 ◽

Cited By ~ 8

Author(s):

Kazuhisa Takahashi ◽

Takashi Dambara ◽

Toshimasa Uekusa ◽

Toshihiro Nukiwa ◽

Shiro Kira

Keyword(s):

Chest Wall ◽

Chest Wall Tumor ◽

Askin Tumor ◽

Wall Tumor

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Painful Chest Wall Swellings: Tietze Syndrome or Chest Wall Tumor?

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0035-1545261 ◽

2015 ◽

Vol 64 (03) ◽

pp. 239-244

Author(s):

Nesimi Gunal ◽

Gultekin Gulbahar ◽

Bulent Kocer ◽

Serdar Han ◽

Mehmet Eryazgan ◽

...

Keyword(s):

Chest Wall ◽

Chest Wall Tumor ◽

Tietze Syndrome ◽

Wall Tumor

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New Trends in Skeletal Reconstruction after Resection of Chest Wall Tumors

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(10)61315-x ◽

1981 ◽

Vol 31 (1) ◽

pp. 45-52 ◽

Cited By ~ 122

Author(s):

Patricia McCormack ◽

Manjit S. Bains ◽

Edward J. Beattie ◽

Nael Martini

Keyword(s):

Chest Wall ◽

Chest Wall Tumors ◽

Skeletal Reconstruction

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Thoracic Surgery Skill Proficiency with Chest Wall Tumor Simulator

Journal of Surgical Research ◽

10.1016/j.jss.2011.01.055 ◽

2012 ◽

Vol 174 (2) ◽

pp. 250-256 ◽

Cited By ~ 10

Author(s):

M. Blair Marshall ◽

Brette M. Wilson ◽

Yvonne M. Carter

Keyword(s):

Thoracic Surgery ◽

Chest Wall ◽

Chest Wall Tumor ◽

Wall Tumor

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Chest Wall Tumors

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239800600314 ◽

1998 ◽

Vol 6 (3) ◽

pp. 212-215 ◽

Cited By ~ 2

Author(s):

B Ali Özuslu ◽

Onur Genç ◽

Sedat Gürkök ◽

Kunter Balkanli

Keyword(s):

Soft Tissue ◽

Chest Wall ◽

Distant Metastases ◽

Metastatic Tumor ◽

Prosthetic Material ◽

Benign Tumors ◽

Chest Wall Resection ◽

En Bloc ◽

Reconstructive Procedures ◽

Chest Wall Tumors

We reviewed 94 consecutive patients who underwent resection of soft tissue or bone tumors of the chest wall between September 1989 and December 1996. There were 3 females and 91 males ranging in age from 12 to 69 years (median, 22.85 years); 16 had a primary malignant tumor, 11 had a metastatic tumor, and 67 had a benign tumor. Sixty-four patients underwent resection of the chest wall skeleton. Overlying soft tissue was resected en bloc in 15 patients. Chest wall defects were not reconstructed with prosthetic material or autogenous grafts because the defects were not large. Soft tissue reconstructive procedures were predominantly muscle transposition. There were no early postoperative complications and the median hospitalization was 14.2 days (range, 6 to 47 days). Follow-up was complete in all patients and ranged from 2 to 36 months (median, 24.5 months). All patients with benign tumors are currently alive. Recurrent chest wall tumors developed in 5 patients and they underwent a second operation. Nine patients died from distant metastases. There were no early or late deaths related to either resection or reconstruction of the chest wall. We conclude that wide or adequate chest wall resection, depending on histopathologic type of tumor, is the key to successful management of chest wall tumors. In general, this procedure can be performed in one operation with a short hospital stay and low operative mortality.

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