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Chest Wall Tumors

The chest (thoracic) cavity is a space that is enclosed by the spine, ribs and sternum (breast bone) and is separated from the abdomen below by the diaphragm. The chest cavity contains the heart, the thoracic aorta, lungs, and esophagus (swallowing passage) among other important organs. The wall of the chest cavity is made up of the rib cage and diaphragm. The chest wall is firm enough to protect the organs in the chest cavity but flexible enough to move outward and inward with respiration (breathing). As is the case with any other structure in your body, the chest wall can develop tumors.

Non-cancerous tumors of the chest wall are relatively common. There are three main types:

  • chondroma
  • osteochondroma
  • fibrous dysplasia
Often, these go completely undetected, and unless they cause symptoms such as pain or trouble breathing, they may not require treatment.

Malignant (cancerous) chest wall tumors on the other hand, are more rare, and do require treatment. These tumors are almost always sarcomas, which means that they are formed from bone, cartilage, and/or soft tissue of the chest wall. Cancerous chest wall tumors are considered either primary (arising from the chest wall) or secondary (spread from a malignancy originating in another organ).

Causes of Chest Wall Tumors

Although the precise cause of chest wall tumors is unknown, it is likely that diet, hereditary factors, and general lifestyle choices can all affect the risk of developing one of these tumors.

Symptoms of Chest Wall Tumors

Symptoms will depend on the type of chest wall tumor. Most present with swelling or chest pain. Tumors originating from cartilage or bone may be found incidentally while showering. Soft-tissue tumors (eg, originating from muscle) often do not cause symptoms until they are quite large.

Diagnosis of Chest Wall Tumors

A variety of diagnostic tests are available to determine the presence and type of chest wall tumor as well as what type of treatment is most appropriate.

    Imaging studies (chest x-rays, CT-scans, and MRI scans) can all help to determine the size and location of the tumor.

    A PET scan can provide information on whether the tumor is cancerous.

    Pulmonary Function Tests help determine whether a patient has enough lung reserve to tolerate an operation to remove a chest wall tumor.

When a chest wall tumor has been identified, a small biopsy may be recommended to document the exact type of tumor. An aspiration biopsy involves the insertion of a needle into the tumor and drawing back on the syringe to extract cells from the tumor which can be examined under a microscope if the location of the tumor makes it difficult to reach with a needle, an open biopsy, which requires a small incision, might be a better option.

Treatment of Chest Wall Tumors

Treatment options will depend upon the type of chest wall tumor found. If the tumor is benign, no treatment may be required, although at times, proving that a chest wall tumor is benign requires that it be removed (excisional biopsy).

The treatment of a malignant chest wall tumor may involve chemotherapy, radiation, or surgery, or a combination of all three. A portion of the rib cage must frequently be removed to eradicate a chest wall tumor; very effective reconstruction (replacement) of the chest wall using adjacent muscle, mesh or mesh with “plastic” material is available. The amount of chest wall that must be removed, the proposed method of reconstruction, and associated risks and benefits of the operation are reviewed by the surgeon with the patient prior to scheduling the procedure.

Take the Next Step

Contact the Thoracic Cancer Clinic at Michigan Medicine to assemble a team of specialists and construct a plan of action.

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