Early result of Excision of 220 cases of primary chest wall tumors in 12 years period.

Authors

  • Muhammad Salim Khan
  • Aamir Bilal
  • Muhammad Imran
  • Abdul Baseer
  • Manzoor Ahmad

Keywords:

Metastases, ChestWall Tumors, Peshawar

Abstract

Objective:To assess the surgical outcomes in primary chest wall tumors.Methodology:  Two hundred and twenty patients from June 2002 to December 2014 were retrospectively analyzed. Patients of all ages, both sexes and operable primary chest wall tumors were included. Clinical evaluation, routine investigation, chest radiographs, computed tomography and biopsy were done. Complete excision of chest wall tumors, with 5cm free margin and removal of one normal rib above and one normal rib below, was done; specimens were sent for histopathology. In skeletal reconstruction plastic surgeon was involved. Patients were sent to oncologist for adjuvant therapy accordingly. One year follow up were done.Results: Out of 220 cases patients 143 (65%) were male and 77 (35%) were female, age ranged from 9 to 80 years with a median of 27.8 years. One hundred and fifty one patient (68.63%) experienced painless mass and 69 (31.3%) painful mass. There were 113 (51.3%) patients presenting with chest wall mass on right side, 70 (31.8%) left sided and 37 (16.8%) on sternum. Sizes were < 3cm 78 (35.4%), 3-5, 92 (41.8%), 5-10 cm 42 (19%) and > 10cm 8 (3.6%). Chest wall resection and primary closure was done in 107 (48.6%) cases while in 113(51%) resection and reconstruction was done, using Marlex Mesh alone in 98 (86.7). cases and reinforced with methyl methacrylate in 15 (13.2%) cases. Histological chondrosarcoma was reported in 134 (61%), Fibrosarcona in 55 (25%), Ewing sarcoma 24 (11%) while 7 (3%) specimens were reported as chondroma. Post operative flail was observed in 8 (3.6%) cases, 5 (2.27%) Patient died despite prolonged ventilation. All alive patients were tumor free at one year follow up.Conclusion:  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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Published

2017-04-21

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Original Article