The chest wall consists of different types of tissue, from the outside inwards these are the skin, connective tissue, fatty tissue and muscles. In principle, all of these tissues can be the starting point for tissue growths (tumors). Doctors then speak of so-called chest wall or thoracic wall tumors. But how are they recognized and treated? - An overview.
Breast wall tumors can be divided into benign (benign) and malignant (malignant) tumors. Up to 39% of chest wall tumors are malignant, while 35% are benign. The remaining 26% are so-called secondary chest wall tumors, i.e. they arise from lung metastases ("daughter tumors") that originate from another cancer focus in the body.
Benign chest wall tumors primarily include
Malignant breast wall tumors, however, include
The most common symptom associated with chest wall tumors is pain in the area of the thorax and chest. Sometimes there is also a palpable swelling on the chest wall. However, warming and redness are described less frequently.
However, chest wall tumors - especially in the early stages - can also be completely asymptomatic. Chest wall tumors are then often discovered by chance during routine examinations, e.g. in computer tomography (CT), on X-rays or in magnetic resonance imaging (MRI).
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If a chest wall tumor is suspected due to symptoms, a CT scan usually provides the best images. In computed tomography, the chest is imaged in individual slices, which allow a very high depth resolution. This allows the location of the tumor to be determined very precisely.
CT is also essential for planning an operation to remove the chest wall tumor. In some cases, it is also necessary to carry out an MRI to assess whether the chest wall tumor is already growing into neighbouring tissue and organs.
Chest wall tumors are usually treated surgically, i.e. the tumor tissue is completely removed if possible. Depending on the tumor location, tumor size and tumor stage, surgery can also be combined with chemotherapy and/or radiotherapy.
In general, chest wall tumors should be removed as extensively as possible to prevent the tumor from returning (recurrence). However, in the case of advanced thoracic tumors, it may be necessary to partially remove the chest wall (= partial chest wall resection).
The resulting defect is then replaced by a chest wall replacement on this part of the thorax. To do this, thoracic surgeons use a bone replacement material and plastic mesh to close off the chest cavity and protect the lungs, for example. Depending on the extent of the procedure, plastic surgeons are also involved to restore the natural appearance of the surgical area.
Overall, the treatment of chest wall tumors is an interdisciplinary task. Thoracic surgeons, neurosurgeons, plastic surgeons and oncologists are all involved.
The prognosis for chest wall tumors depends primarily on the stage of the tumor and how far it has spread. However, the earlier a tumor is detected, the better the chances of a possible cure.
In addition, the surgical result also influences the further outcome. Particularly in the area of soft tissue breast wall tumors, this is ensured by wide incision margins right into the healthy tissue. In this way, recurrences - the return of a tumor - can be prevented.
A dissertation from 2012 also showed that thoracic surgery, in particular chest wall resection and reconstruction, are safe operations. Mortality (death rate) and morbidity (burden of disease) are low compared to the severity of the procedure.
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