tumors of the thoracic wall

Question 1

origin and types

Answer 1

• Bone / soft tissue in origin.

* Benign / malignant.

Question 2

benign rib tumors

Answer 2

osteochondroma
chondroma
fibrous dysplasia
histiocytosis X

Question 3

malignant rib tumors

Answer 3

multiple myeloma - most common primary malignant rib neoplasm

osteosarcoma

chondrosarcoma - second place

Ewing’s sarcoma

Question 4

differentiation

Answer 4

Differentiation between chondroma & chondrosarcoma is not possible by clinical presentation & imaging (must be considered malignant & treated by a wide excision).

Question 5

which tumors should be considered malignant?

Answer 5

All tumors arising in the costal cartilages should be considered malignant!

Question 6

osteosarcoma

Answer 6

less favorable prognosis than chondrosarcoma

usually in adolescents and young adults who present with rapidly enlarging, painful tumors

Question 7

malignant fibrohistocytoma

Answer 7

most common malignant soft tissue tumor

usually presents as painless, slowly growing mass

Question 8

mesothelioma

Answer 8

• 50% of patients with mesothelioma have history of exposure to asbestos.
• Diffuse mesotheliomas are usually malignant.
• Symptoms of diffuse malignant mesothelioma include dyspnea, weight loss, cough & severe pain.
• Pleural effusion (usually present).

Question 9

tumors suspected of being primary neoplasms

Answer 9

should be diagnosed by excisional (complete removal) rather than incisional (partial removal) biopsy.

Question 10

After diagnosis of primary chest wall neoplasm:

Answer 10

objective of surgical intervention is wide excision.