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. 2022 May 12;17(1):116.
doi: 10.1186/s13019-022-01877-9.

Resection and reconstruction of huge tumors in the chest wall

Zhibing Dai  1 , Maierdanjiang Maihemuti  1 , Yachao Sun  1 , Renbing Jiang  2
Affiliations

Resection and reconstruction of huge tumors in the chest wall

Zhibing Dai et al. J Cardiothorac Surg. .

Abstract

Objective: To evaluate the experience and effects of resection and reconstruction of 4 cases of huge tumors in the chest wall.

Methods: The clinical data of 4 patients with huge tumors in the chest wall from July 2015 to January 2020 were collected and analyzed. There were 2 males and 2 females.Chondrosarcoma was diagnosed in 2 cases, giant cell tumor was diagnosed in 1 case,and metastasis from breast cancer was diagnosed in 1 case.All patients underwent extensive tumor resection and had thoracic exposure after tumor resection.Two patients underwent reconstruction with mesh and titanium mesh, and the incision was closed directly.The third patient underwent reconstruction with mesh and latissimus dorsi flap,and the fourth patient underwent reconstruction with mesh,titanium mesh and latissimus dorsi flap.

Result: One patient had incision infection after operation,which resolved after debridement.All patients were followed up for 2-6 years, no tumor recurrence or metastasis was noted during follow-up.None of patients had abnormal breathing, dyspnea or other physical discomfort.

Conclusion: It is difficult to resect the huge tumors in the chest wall,and it is more reasonable and safer to choose a reconstruction method using mesh and titanium mesh.The latissimus dorsi flap can achieve good results in repairing soft tissue defects.Close perioperative management and multidisciplinary team discussions can help to achieve better curative effects.

Keywords: Chest wall tumor; Multidisciplinary; Perioperative period; Reconstruction; Resection.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A-B CT showing a huge tumor protruding into the chest wall. C The invading lung tissue was resected during the operation. D Postoperative specimen. E Reconstruction chest wall with mesh and titanium mesh. F Postoperative CT showed that the lung recovered well
Fig. 2
Fig. 2
A The huge tumor in the right chest wall was observed that invaded the ribs and partially invaded the sternum. B Postoperative chest film,reconstruction by mesh and titanium mesh. C The position of the titanium mesh after the operation appeared to be good on CT, and the lung recovered well
Fig. 3
Fig. 3
A Giant tumor in the upper chest wall. B MR showed that the tumor bilaterally invaded the clavicle, 1st and 2nd ribs, and the pleura, along with the anterior mediastinum and left subclavian vein. C 3D printing model showed a huge tumor in the anterior chest wall. D After tumor resection, the thorax was exposed bilaterally. E Tumor specimen. F The latissimus dorsi flap survived well at 3 weeks after the operation
Fig. 4
Fig. 4
A A huge tumor on the left chest wall and an old scar on the left chest wall B Huge tumor on the left chest wall that invaded ribs 1–4, the sternum and lung tissue. C 3D printed model showing the huge tumor in the left anterior chest wall. D The chest wall defect was repaired with mesh E The titanium mesh on the polypropylene mesh. F The soft tissue defect was repaired with a latissimus dorsi myocutaneous flap, which grew well at one month postoperatively
See this image and copyright information in PMC

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