Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Up to 50% of all malignant chest wall masses• Only 5% of all malignant soft-tissue sarcomas located in chest wall• Prognosis determined by histologic grade, completeness of resection, and metastatic disease• Metastasize commonly to lungs (75%)• Types of tumors: -Desmoids: Low grade-Fibrosarcoma: Most common in this location, especially in young adults-Liposarcoma: 33% of all primary cancers of chest wall, especially in men-Neurofibrosarcomas: 2 × more common in this location than any other, often in Recklinghausen disease, originating from intercostals nerves +++ Imaging Findings + • US, CT, and MRI can be useful + • Most often metastasize to lungs +++ Rule Out + • Metastatic disease with chest CT + • Physical exam• Chest x-ray• Chest CT scan• Incisional or excisional biopsy depending on size and configuration + • Resection goal is to achieve negative margins (1-2 cm)• Marlex mesh/methyl methacrylate to correct chest wall deformity• Soft-tissue flaps for coverage• Positive margins: Radiation therapy• Adjuvant chemotherapy if high grade +++ Surgery +++ Indications + • Resectable lesion• Localized metatstatic disease to lungs if amenable to negative margins +++ Prognosis + • Depends on histologic grade-Low grade: 5-year survival, 90%-High grade: 5-year survival, 30-50%• Completeness of surgical resection helps determine• Metastases greatly decrease survival +++ References ++Burt M. Primary malignant tumors of the chest wall. The Memorial Sloan-Kettering Cancer Center experience. Chest Surg Clin North Am. 1994;4:137. [PubMed: 8055278] +++ Practice Guidelines + • The National Comprehensive Cancer Networkhttp://www.nccn.org/ Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth