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

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.

Aortic valve replacement and coronary artery bypass grafting through a right thoracotomy for a patient with a left chest wall tumor

A 68-year-old man was diagnosed with severe aortic stenosis and right coronary artery occlusion on preoperative examination for total extirpation of a giant left breast liposarcoma. Prior to the intervention for the liposarcoma, he underwent successful aortic valve replacement and coronary artery bypass grafting via a right anterolateral thoracotomy to avoid the tumor close to the sternum. On postoperative day 28, the patient underwent a successful wide excision of the left chest wall tumor.

Low-grade chondrosarcoma mimicking breast cancer

Chondrosarcomas are rare cartilage-like mesenchymal tumors. Some rib-sited tumors can mimic other common tumors. We present the case of a 24-year-old female with chondrosarcoma of the fourth left rib, mimicking breast cancer. Complete resection with chest wall reconstruction was performed successfully with good prognostic results. Physicians should bear in mind the possibility of a primary chest wall tumor mimicking breast cancer that needs a different therapeutic strategy. Complete surgical resection and chest wall reconstruction is the mainstay of treatment for chondrosarcoma.

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

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.