Chest wall refers to the rigid framework which houses and protects various organs in the chest. It is composed of muscles and bones and other soft tissues. Any of these tissues can develop a tumour which is basically an abnormal growth of cells. These tumours can be benign (non-cancerous) or Malignant (cancerous).
The chest wall tumours can further classified into Primary and Secondary Tumours. Primary tumours are those which arise from the muscle and bones of the chest wall. Whereas, secondary tumours are those which arised from somewhere else in the body and have spread to chest wall. These are called metastasis.
The most common benign tumours are osteochondromas and chrondromas. The most common malignant chest wall tumours are sarcomas. The tumours of the chest wall that develop in children are mostly primary was those that develop in adults are mostly secondary. The commonest symptom of these tumours are a lump or swelling on the chest.
The most common symptom of Chest wall Tumour is a lump or a swelling felt or seen on the chest wall. There may be other associated symptoms like pain. Large benign tumours or malignant tumours may have more severe pain and limitation of chest expansion.
Most chest wall swellings are initially evaluated using a Chest Xray. If an abnormality is detected on a Chest Xray a CT scan (computed tomography) or MRI (magnetic resonance imaging) scan is required to further evaluate the swelling in detail. Some patients may require a whole body PET scan if there is suspicion of malignant tumour to asses the spread of disease and to stage the disease.
The next most important step is to find out what kind of tumour it is (Benign or Maligmnant). This is most commonly done as a needle (Tru-cut core) biopsy wherein a small portion (core) of tumour tissue is removed using a special needle for pathological examination.
If for some reason the tumour cannot be accessed by a needle and open biopsy (incisional biopsy may be required).
The treatment of the tumour will depend mainly on the biopsy report. In case of benign tumours surgical removal of the tumour is contemplated if it is symptomatic (like pain), large in size or interfering with normal physiological functions.
In cases of malignant tumours, the treatment will depend on the exact pathology of tumour and also the stage of the disease. It can include a combination of chemotherapy, radiation therapy and surgical removal and reconstruction.
Many a times, surgery for chest wall tumours involves the removal of a portion of the chest wall with the ribs and the muscles to achieve complete eradication of tumour. This leads to a chest wall defect that is reconstructed using mesh, titanium plates in place of ribs and adjacent muscle with the help of Plastic surgery. The extent of resection and the technique required for reconstruction varies from patient to patient and is tailor made to the requirement of a specific patient.