Soft-Tissue Sarcomas of the Chest Wall

Gross, Jefferson Luiz; Younes, Riad Naim; Haddad, Fábio J.; Deheinzelin, Daniel; Pinto, Clóvis Antônio Lopes; Costa, Marcelo Leite Vieira

doi:10.1378/chest.127.3.902

Cited by 77 publications

(83 citation statements)

References 20 publications

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“…Besides, in many studies patients with rhabdomyosarcoma, bone and cartilagious chest wall tumors, borderline tumors like desmoids tumors, dermatofibrosarcoma protuberans and patients with tumors metastatic to the chest wall were included in the analysis (Pairolero et al, 1985;Coindre et al, 2001;Athanassiadi et al, 2001;Warzelhan et al, 2001;Salas et al, 2009;Tsukushi et al, 2009;Van Geel et al, 2011). Few studies focused exclusively on soft tissue tumors originally from chest wall alone are available (Greager et al, 1987;Gordon et al, 1991;Gross et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…Greager et al analyzed 49 patients with STS of the thoracic wall and noted that all 10-year survivors had tumors with low grade or <5cm in diameter (Greager et al, 1987). Gross et al also noted that tumor size less than 5 cm was determinants of a better DFS and OS (Gross et al, 2005). One of the largest series of patients who had softtissue sarcomas of the chest wall was reported by Gordon et al (1991).…”

Section: Discussionmentioning

confidence: 99%

“…Soft-tissue sarcomas (STS) comprise approximately 1-1, 5% of all malignancies in adults and less than 10% of soft tissue sarcomas are located in the thoracic wall (Gross et al, 2005;Jamal et al, 2010). Clinical findings may vary from asymptomatic up to palpable mass, pain and ulceration.…”

Section: Introductionmentioning

confidence: 99%

“…Thoracic wall STS were usually evaluated together with STS of other primary sites or bone and cartilaginous chest wall tumors due to their rarity (Pairolero et al, 1985;Athanassiadi et al, 2001;Coindre et al, 2001;Warzelhan., Gross et al, 2005;Salas et al, 2009;Tsukushi et al, 2009;Jamal et al, 2010;Shah et al, 2010;Van Geel et al, 2011;Berna et al, 2012;Roger et al, 2013). While there are limited data about the prognostic factors for the patients with primary thoracic wall STS, they are generally treated like extremity sarcomas since the prognostic factors and the clinical behavior of thoracic wall sarcomas assumed to be similar to extremity STS (Greager et al, 1987;Gordon et al, 1991;Gross et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

“…While there are limited data about the prognostic factors for the patients with primary thoracic wall STS, they are generally treated like extremity sarcomas since the prognostic factors and the clinical behavior of thoracic wall sarcomas assumed to be similar to extremity STS (Greager et al, 1987;Gordon et al, 1991;Gross et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Treatment Results in Soft Tissue Sarcomas of the Thoracic Wall Treated with Pre-or-Postoperative Radiotherapy - a Single Institution Experience

Öksüz¹,

Özdemir²,

Kaydıhan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Objective: To evaluate the long term results among patients with soft tissue sarcoma of the thoracic wall. Materials and Methods: Twenty-six patients who were treated with pre-or postoperative radiotherapy between December 1980-December 2007, with a diagnosis of soft tissue sarcoma of the thoracic wall were retrospectively evaluated. Results: The median age was 44 years (14-85 years) and 15 of them were male. A total of 50% of patients were grade 3. The most common histologic type of tumor was undifferentiated pleomorphic sarcoma (26.9%). Tumor size varied between 2-25 cm (median 6.5 cm). Seventeen of the cases had marginal and 9 had wide local resection. Four cases received preoperative radiotherapy and 22 postoperative radiotherapy. Six of the patients with large and high grade tumors received chemotherapy. Median follow-up time was 82 months (9-309 months). Local recurrence and metastasis was detected in 34.6% and 42.3% of patients, respectively. Fiveyear local control (LC), disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) were 62%, 38%, 69%, and 76% respectively. On univariate analysis, the patients with positive surgical margins had a markedly lower 5-year LC rate than patients with negative surgical margin, but the difference was not significant (43% vs 78%, p=0.1). Five-year DFS (66% vs 17%) and DSS (92% vs 60%) rates were significantly worse for the patients who had high grade tumors (p=0.01, p=0.008 respectively). Conclusions: Tumor grade and surgical margin are essential parameters for determining the prognosis of thoracic wall soft tissue sarcoma both in our series and the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Long-Term Treatment Results in Soft Tissue Sarcomas of the Thoracic Wall Treated with Pre-or-Postoperative Radiotherapy - a Single Institution Experience

Öksüz¹,

Özdemir²,

Kaydıhan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

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Enlarging Breast Mass in a 55-Year-Old Woman

et al. 2014

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A 55-year-old woman presented to the clinic with a mass in her left breast that had been enlarging over the previous 3 months. The patient denied any antecedent trauma or infection. Her medical history was significant for hypertension and left breast invasive ductal carcinoma in 2007 treated with lumpectomy and adjuvant radiation as well as synchronous rectal cancer after neoadjuvant chemoradiation and abdominoperineal resection. As part of her treatment course, the patient received a total dose of 50.5 Gy pelvic irradiation and 60 Gy irradiation to the left breast and axillary basin. The patient was followed up with yearly computed tomography of the abdomen and pelvis in addition to yearly digital mammography. Her last mammogram, 5 months prior to presentation, was unremarkable. On physical examination, she had a hard, well-circumscribed, fixed mass in the upper, outer quadrant of her left breast. The lesion was not tender to palpation nor was there any associated axillary or supraclavicular lymphadenopathy. Examination of the nipple as well as the contralateral breast and axilla was unremarkable. Computed tomography of the thorax revealed a 6.7 × 4 cm mass arising from the left chest wall distinct from the left breast with extent to the pleural surface of the left thorax (Figure, A). Positron emission tomography revealed metabolic activity within the mass but did not reveal any distant disease. Core needle biopsy confirmed the diagnosis and the patient was offered resection with reconstruction.The patient underwent a left radical mastectomy including resection of the pectoralis major and minor and resection of the adjacent chest wall resulting in a chest wall defect spanning ribs 2 through 4 (Figure, B). The patient underwent immediate reconstruction of the chest wall with 2-mm-thick expanded polytetrafluoroethylene and latissimus dorsi pedicle flap reconstruction of the soft tissue defect and breast mound. A B Figure.A, Computed tomographic axial section of the thorax illustrating a left chest wall mass measuring 6.7 × 4 cm apparently distinct from the left breast parenchyma with possible pleural invasion. B, Postresection wound including chest wall. Lung parenchyma adjacent to the chest wall reveals stippling and fibrosis consistent with previous irradiation.

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