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What are Chest Walls?

The chest wall is a bony structure made of the rib cages (ribs and muscle) and sternum (breast bone), which surrounds and protects vital structures like Lungs and Heart. The chest wall though is a rigid frame but is a dynamic structure that helps in respiration.

Tumors

Chest Wall Tumors are rare and classified into Primary Chest Wall Tumors arising from muscles and bone of the Chest Wall or Secondary Tumors are malignant only which arise elsewhere in the body but spread to the Chest Wall. Primary Chest Wall Tumors can be benign like Chondroma, Osteochondroma, Fibrous dysplasia, etc. While Malignant Chest Wall Tumors are Chondrosarcoma, Osteosarcoma, Ewing's Sarcoma and Sarcomas arising from muscles and soft tissues.

  • Highly modified Ravtich technique for pectus excavatum, which removes cartilage and elevates the breastbone with two stainless steel struts inserted through a small vertical incision in the mid-chest
  • Nuss procedure, a type of VATS (video-assisted thoracic surgery) generally used for adolescent patients with pectus excavatum, in which a curved steel bar (known as the Lorenz Pectus Bar) is inserted through two small incisions under the sternum. It pushes out the depression and is then fixed to the ribs on either side.
  • Ostomy procedure for pectus carinatum, in which small bone cuts in the breastbone smooth out the contour and resolve rotation of the bone
  • Signs and Symptoms

    Most of the time Chest Wall Tumors manifest as the mass in chest, pain or soreness in the chest, protrusion of chest wall and impaired chest movement.

    Diagnosis

  • Chest X-Ray, CT scan with MRI better with 3d reconstruction to know the exact extent of disease and helps in planning Surgery. PET scan is also needed in case of malignant Chest Wall Tumors. A biopsy with histological confirmation is required to plan the treatment.
  • Treatment

  • Most of Chest Wall Tumors are treated by surgical resection with reconstruction with Myocutaneous flap and Prosthesis (mesh, bone cement, and titanium plate), Large defects are sometimes difficult to reconstruct and may interfere in respiratory dynamics. Other type of Tumors like Round Cell Sarcoma, Ewing's Sarcoma, Plasmacytoma, etc are treated with multimodality treatment mainly Chemotherapy Radiotherapy and sometimes Surgery.
  • Service

    Other Symptoms

    • Thoracic outlet syndrome symptoms include pain, tingling or weakness in the shoulder and arm, especially when raising the arms.
    • Chest wall malformations may have no symptoms other than an unusual appearance of the chest. Some people with pectus excavatum may experience:
    • Chest pain
    • Decreased tolerance for exercise
    • Fast heart rate (tachycardia)
    • Fatigue
    • Shortness of breath
    • Chest wall cancers sometimes have no symptoms. People who experience symptoms usually have one or more of the following:

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