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The aim of the study is to evaluate clinical applications, safety, and effectiveness of a porcine-derived acellular cross-linked dermal matrix biological mesh in chest wall reconstruction.We retrospectively analyzed a prospective multicenter database of chest wall reconstructions using a biological mesh in adult patients undergoing operation between October 2013 and December 2020. We evaluated preoperative data, type of resection and reconstruction, hospitalization, 30-day morbidity and mortality, and overall survival.A total of 105 patients (36 women [34.2%]; mean age, 57.0 ± 16.1 years; range, 18-90 years) were included, they have admitted for: primary chest wall tumor (n = 52; 49.5%), secondary chest wall tumor (n = 29; 27.6%), lung hernia (n = 12; 11.4%), trauma (n = 10; 9.6%), and infections (n = 2; 1.9%). The surgical sites were preoperatively defined as at high risk of infection in 28 patients (26.7%) or as infected in 16 (15.2%) patients. Thirty-days morbidity was 30.5% (n = 32 patients); 14 patients (13.3%) had postoperative complications directly related to chest wall surgical resection and/or reconstruction. We experienced no 30-day mortality; 1-year and 2-year mortality was 8.4% and 16.8%, respectively.Biological mesh represents a valuable option in chest wall reconstruction even when surgical sites are infected or at high-risk of infections. This mesh shows low early and late postoperative complication rates and excellent long-term stability.

Chondrosarcoma (CS) is a primary chest wall tumor causing huge masses arising from rib, sternum or costochondral junction. Successful treatment warrants complete surgical resection with wide, free margins followed by reconstruction of the bony chest wall and soft tissue coverage of the defect. We report the case of excision of giant recurrent sternal CS followed by reconstruction of Neo-sternum using steel wires. This novel technique portrays steel wire-based reconstructions as a safe, reproducible and readily available prosthetic material for complex chest wall surgeries.

The incidence rate of tuberculosis in developed countries is low. The most common presentation of this disease is its pulmonary form but with the increasing use of immunosuppressive drugs, extra-pulmonary tuberculosis is re-emerging. Nevertheless, sternal bone involvement is uncommon. We report the case of an eighty-three-year-old man who presented a painful sternal mass which progressed towards cutaneous ulceration. The first diagnostic hypothesis was neoplasia. The pathological and microbiological diagnosis of tuberculosis was achieved after surgical biopsy. The patient received treatment against tuberculosis for nine months enabling recovery without surgery. This case illustrates the importance of having a diagnosis prior to any kind of treatment facing any voluminous parietal thoracic lesions. This diagnosis is made possible by surgical samples and interdisciplinary teamwork. This case underlines that tuberculosis remains a differential diagnosis that must be evoked in case of unusual bone mass.

Introduction Regardless of its rarity, and indolent clinical course, chest wall tumor places high morbidity and burden on patients especially when invasion to a neighboring structure is found. Once detected, surgery is the cornerstone for treatment of such etiology combined with chemo-radiotherapy. In order to maintain intact respiratory function, chest wall reconstruction must be performed whenever resection is done. Herein, we present a case of chest wall tumor that necessitated three ribs and part of hemidiaphragm resection and reconstruction with optimal post-operative results. Case presentation A 27-year-old male patient who had chest wall and diaphragm reconstruction for a chest wall Ewing sarcoma, using a single patch of expanded polytetrafluoroethylene (ePTFE) mesh with diaphragm implanted into the middle of the mesh. There were no immediate nor post-operative complications. The patient received post-operative radiotherapy with good functional and cosmetic results. Conclusion We present a novel and safe technique for combined chest wall and diaphragmatic resection following excision of an invading tumor while ensuring cosmesis and functionality of the ribcage as well as the diaphragm.

Chondrosarcomas are rare cartilage-like mesenchymal tumors. Some rib-sited tumors can mimic other common tumors. We present the case of a 24-year-old female with chondrosarcoma of the fourth left rib, mimicking breast cancer. Complete resection with chest wall reconstruction was performed successfully with good prognostic results. Physicians should bear in mind the possibility of a primary chest wall tumor mimicking breast cancer that needs a different therapeutic strategy. Complete surgical resection and chest wall reconstruction is the mainstay of treatment for chondrosarcoma.

Highlights • Intercostal hemangioma is an extremely rare disease, accounting for approximately 0.01% of all benign hemangiomas. • Hemangiomas are prone to bleed spontaneously or after minor traumatic injury. • Complete excision of the tumor is mandatory even after embolization to prevent recruitment of a collatera1 blood supply., Introduction Intercostal hemangioma is an extremely rare disease. It is difficult to distinguish intercostal hemangioma from other chest wall tumors. The difficulty in preoperative diagnosis may result in incomplete surgical resection and hence a high rate of recurrence. Case presentation A 14-year-old boy who presented with asymptomatic right lateral chest wall mass with no history of trauma. Different radiological modalities were employed for diagnosis including computed tomography (CT) showed a soft tissue mass 6.5 × 4 × 5.6 cm in size abutting 5th and 6th ribs. Magnetic resonance imaging (MRI) revealed iso-intense signal in T1 and hyperintense signal in T2, that is higher than that of adjacent muscles in the inferolateral right chest wall which was compatible with intercostal hemangioma. The patient underwent surgery for excision of the mass. Through right posterolateral thoracotomy, there was a well-demarcated mass abutting 5th, and 6th ribs filling the right 5th interspaces. Histopathological examination confirmed the diagnosis of intercostal hemangioma. Discussion Chest wall hemangiomas are uncommon and mostly arise outside the rib cage. Hemangiomas rarely occur in the intercostal space, and most of these originate from intercostal muscles (Agarwal et al., 2006). Watson and McCarthy postulated two theories for the etiology of hemangiomas. The more widely supported theory claims that hemangiomas are of congenital origin. The other theory proposes a traumatic origin of hemangiomas. Conclusion Complete surgical resection should not be compromised by the resultant chest wall defect to prevent recurrence.

Purpose: To describe a case of giant intercostal nerve schwannoma successfully resected in a patient with neurofibromatosis type 2. Methods: A 44-year-old woman, with a history of neurofibromatosis type 2, presented with chest discomfort and mild dyspnea. She had undergone a recent resection of a large frontal parasagittal benign meningioma. Radiologic examinations showed a large lesion (9×12×9 cm) of the left hemithorax causing a complete atelectasis of left upper lobe. Bronchoscopy did not show any endobronchial alterations, apart from an ab estriseco compression of the left upper bronchial tree. A transthoracic needle biopsy was then performed and microscopic examination revealed a mesenchymal tumor composed of spindle-like cells. Results: A video-assisted thoracoscopic surgery procedure was proposed. The tumor mass appeared to be tenaciously adherent to the parietal pleura in its anterolateral aspect, confirming the radiologic appearance. No invasion of the lung parenchyma or parietal pleural metastases were visible. Therefore, a left posterolateral thoracotomy at the fifth intercostal space was performed and a macroscopic complete resection was carried out. The recovery was uneventful and the patient was discharged on postoperative day 5. The histologic examination revealed a moderate cellular proliferation of spindle-shaped and oval to polygonal cells with frequent Verocay bodies; mitotic figures were rare. The tumor cells were strongly S-100 positive. The microscopic features were consistent with benign intercostal schwannoma. Eight years later, the patient is disease-free and asymptomatic. Conclusions: An unusual case of giant intercostal nerve schwannoma successfully resected in a patient with neurofibromatosis type 2 is described.

Chest wall resection is traditionally performed via open thoracotomy, a procedure that increases surgical morbidity and reduces postoperative quality of life. Conversely, thoracoscopic chest wall resection may minimize invasiveness but the optimal procedure remains uncertain. We previously reported rib resection using a pneumatic high-speed power drill during video-assisted thoracoscopic surgery for selected lung cancer patients. In this report, we present two cases of chest wall tumor resected using the drill via the thoracoscopic approach. We also report thoracoscopic chest wall reconstruction in one patient using a patch sheet.

Primary osseous tumors of the chest wall are uncommon neoplasms. They occur in a wide variety of pathologic forms, most of which can be distinguished by unique radiologic appearance. Management of these tumors depends on the diagnosis and stage. Adequate surgical resection is critical in achieving the best outcomes for most of these tumors. Chemotherapy and radiation may have an adjuvant role. Surgeons considering resection of any chest wall tumor should have a sound knowledge of the principles of resection and reconstruction.

Fil: Olivera Lopez, Soledad Belen. Instituto Universidad Escuela de Medicina del Hospital Italiano; Argentina

Introduction: Giant cell tumours account 5% of all bone tumours. However, the anterior chest wall is rarely involved . Clinical case: This is a 68-year-old housewife who has been thyroidectomized, for 11 years and is under hormone replacement therapy, and hysterectomized for 6 years after a uterine tumor. She is present for the onset of a 5 month old hard submammary mass on the left associated with left anterior chest pain under mammals. The clinical examination had found an irregular hard mass under left mammary which is fixed to the anterior arch of the 4th left rib. A thoracic x-ray showed a limited left hilo-axillary with an homogenously dense opacity. The thoracic CT scan showed the presence of a thoracic parietal mass of osteolytic tissue density centered on the anterior arch of the 4th left rib; without contrast agent, the surgical exploration through thoracotomy revealed a thoracic parietal tumoral process at the expense of the anterior arch of the 4th limb pushing the corresponding lung inwards. Surgical excision allowed ablation of the whole tumor in monobloc towards a healthy zone. The anatomopathological study of the operative specimen showed a morphological and histopathological aspect compatible with a costal tumor with giant cells. The postoperative recovery was marked by a good clinical and radiological improvement. The last check up after the surgery revealed that the patient was still asymptomatic. Good clinical, biological and radiological improvement was noted with a decline of 8 months. Conclusion: Giant cell tumors are aggressive bone tumors, yet histologically benign. The chosen examination is a thoracic CT scan with surgical treatment. A clinical and radiological monitoring is necessary. The recurrence is rare, but it usually necessitates a second surgery. The objective of this clinical observation is to highlight the possibility, although rare, of a giant cell tumor in case of the swelling of the soft parts, and a lytic lesion of the anterior part of a rib. Therefore, this tumor must be added to the list of diagnoses to be mentioned in this situation.

Chest wall tumor usually requires enbloc resection of tumor with overlying skin, adjoining ribs, and occasionally sternum. An ideal prosthetic material to cover the bony defect as well as maintain respiratory mechanics is yet to be developed. Commonly available methods include combination of the mesh with rigid metallic plates, bone cement, etc., over the skeletal defect, which is then covered with a muscle flap. Here, we are reporting a case of Chondrosarcoma Rib in which rib was reconstructed using non-rigid stainless steel wire, which is easily available and simple to perform.

Erector spinae plane block has been described to manage post-thoracotomy pain. It is a simple block and shown to be provide effective analgesia. In single shot blocks opioid supplementation may be required to manage pain after the effect of local anesthetic wears off. In this case, we describe a case of chest wall tumor excision in a child who received clonidine in addition to local anesthetic for the erector spinae plane block. This provided long lasting and effective postoperative analgesia and may be considered to prolong the analgesia achieved with erector spinae plane block.

A chest wall schwannoma arises from peripheral nerve sheath Schwann cells of the intercostal nerves. We describe the presentation and imaging findings of a patient who presented with a chest wall swelling. The imaging findings were highly suspicious for a chest wall schwannoma and the histopathology confirmed the diagnosis following surgical excision. Imaging findings are reviewed in detail.

WOS: 000373738300011 PubMed: 25742551 Background Tietze syndrome (TS) is an inflammatory condition characterized by chest pain and swelling of costochondral junction. Primary chest wall tumors may mimic TS. In this article, we report our experience of approximately 121 patients initially diagnosed as TS and determined chest wall tumor in some cases at the follow-up. Methods This is a retrospective review of patients diagnosed as TS by clinical examination, chest X-ray, electrocardiogram, routine laboratory tests, and computed tomography (CT) of chest: all treated and followed up between March 2001 and July 2012. There were 121 cases (41 males and 80 females; mean age, 39.6 +/- 3.2 years) of TS. Results In 27 patients with initial normal radiological findings, the size of swellings had doubled during the follow-up period (mean, 8.51 +/- 2.15 months). These patients were reevaluated with chest CT and bone scintigraphy and then early diagnostic biopsy was performed. Pathologic examination revealed primary chest wall tumor in 13 patients (5 malignant, 8 benign). CT had a sensitivity of 92.3% and a specificity of 64.2% in detection of tumors (kappa: 0.56, p = 0.002), whereas the sensitivity and the specificity of bone scan were 84.6 and 35.7%, respectively (kappa: 0.199, p = 0.385). Conclusion Primary chest wall tumors could mimic TS. Bone scintigraphy or CT is not specific enough to determine malignant and other benign disorders of costochondral junction. Therefore, clinicians should follow TS patients more closely, and in case of increasing size of swelling, early diagnostic biopsy should be considered.

Malignant triton tumor is a rare malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation. Most of these tumors are located in the head, neck, and extremities, and about half of cases are associated with neurofibromatosis type 1 featuring cafe-au-lait spots or cutaneous neurofibromas. We present a 76-year-old man with an insidious chest wall tumor with late progressive painful enlargement and pleural and pulmonary involvement. Complete resection of the affected thoracic wall as well as single separate lesions in the parietal pleura and left upper lung was carried out. The pathological examination confirmed that it was a malignant triton tumor. The patient received adjuvant chemoradiotherapy but eventually succumbed to disease relapse and distant metastases 6 months after the surgery.

Nodular fasciitis is a benign reactive proliferation that usually involves the deep fascia. Although it is relatively common in the adult population, it is often misdiagnosed as sarcoma due to its rapid growth and pathological features. It rarely presents as a chest wall tumor in young patients. Here, we report a case of nodular fasciitis involving the chest wall of an 18-year-old woman and its surgical management. This case underscores the need to consider nodular fasciitis in the differential diagnosis of chest wall tumors in young patients.

Giant cell fibroblastoma (GCF) is an unusual tumor of childhood, primarily occurring in the superficial soft tissues. It is often presented in early childhood as a slowly growing, infiltrative subcutaneous mass at a wide variety of sites. Aim: to present such an interesting rare case of pediatric chest wall lesion. Case report: A 4 years old male patient was admitted to the pediatric surgery unit with complaints of a slow-growing painless palpable, firm swelling in the left chest wall below the left breast. All initial assessments were done, surgery was created. Histopathology and immunohistochemistry revealed the distinctive images of GCF. Conclusion: Although the giant cell fibroblastoma is a rare chest wall tumor in the pediatric age group, it must be considered in differential diagnosis. The histopathology approached has more precise and distinctive images for decision-making regarding the surgery.

Chondrosarcoma of a rib is a very rare malignant tumor of the bone. Most patients were present with an enlarging painful anterior chest wall tumor. We present a case of an asymptomatic 29-years old female with a tumor size of 10cm×12cm on the left anterior chest wall involving the 8th rib. CT scan with intravenous contrast is the gold standard for radiological imaging and planning for surgery. Since chondrosarcoma is less sensitive to chemotherapy and radiotherapy, surgical treatment with extensive resection with a sufficient margin is considered first line treatment.

Primary chest wall tumors occur infrequently; in particular, cavernous hemangioma of the chest wall is an extremely rare disease. We report a case of child with cavernous hemangioma of the chest wall, which was successfully resected. Obvious enlargement of the tumor and the appearance of pain were observed during a 2-year follow-up. In the present case, transcutaneous ultrasonography showed the appearance and disappearance of the mass. This was considered to be caused by the transfer of contents between the shallow and deep parts of the tumor. This may have resulted from serratus anterior muscle movement between the two-layered tumor. Transcutaneous ultrasonography, as well as magnetic resonance imaging, was therefore extremely effective for preoperative diagnosis. Transcutaneous ultrasonography is easily performed, even in children, such as in the present case. Because of its simplicity and usefulness, transcutaneous ultrasonography may be considered as the first-line imaging modality for diagnosis.

Correspondence: Dr. Recep Demirhan. Saraylar Caddesi, Basaran Apt., No: 42/2, Cevizli, Kartal, Istanbul Phone: +90 216 458 30 11 Received: 11.07.2016 Accepted: 19.07.2016 Online date: 22.07.2016 e-mail: recepdemirhan@hotmail.com 1Department of Thoraxic Surgery, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey 2Department of Plastic Surgery, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey 3Department of Family Medicine, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey

Ewing sarcoma is a rare tumor, which represents, nevertheless, the most common primary chest wall tumor in children. The management and prognosis of these tumors have markedly improved with the use of multimodal therapy including adjuvant chemotherapy, surgery and/or irradiation. A good response to chemotherapy often avoids the need for extensive local treatment without sacrificing local control or long-term survival. Here, we report a new case of a bulky rib Ewing sarcoma, well managed by neoadjuvant chemotherapy resulting in significantly tumor shrinking that allowed complete resection. At the histological examination of the specimen, there was only inflammatory and fibrosis tissues without viable tumoral tissue.

Summary Purpose of the study Desmoid-type fibromatosis is a fibroblastic proliferation that develops in the deep soft tissues and is characterized by infiltrative growth and a tendency towards local recurrence but does not metastasize. Fibromatosis of the chest wall is rare, representing only 10 to 20% of all deep fibromatoses. Case report We report a six cases series of fibromatosis of the chest wall treated at our institution between 1996 and 2009. There were five men and one woman with a mean age of 42.2. Swelling of the chest wall was the most frequent symptom. Imaging showed an expansive homogeneous mass, invading the rib (four cases) or the sternum (two cases). Surgical resection was performed in all cases. The outcome was favorable (five cases) or marked by local recurrence (one case). Discussion Although it is considered to be a benign lesion, this tumor can be locally very aggressive, and has a high local recurrence rate depending upon the efficacy of surgical resection.

A 54-year-old woman was admitted to the thoracic surgery department for chest mass with pain unresponsive to pain killers of 4 years’ duration. On physical examination, the lesion was observed as painful enlargement of the left second rib. The patient was investigated and underwent resection of the mass. The pathologic study revealed that it was cavernous hemangioma. Hemangiomas involving the rib are extremely rare, with only few cases described in the literature.

Objective To summarize the experience in diagnosis and surgical treatment of 105 cases with a tumor of the chest wall, and to investigate reconstruction of a large chest-wall defect after resection of a chest wall tumor.

背景．肺癌の胸壁浸潤か胸壁腫瘍の肺浸潤かは通常肉眼的組織学的に鑑別しうるが，ごく稀に原発部位が不明な腫瘍を認める．症例．患者は43歳男性．主訴は背部痛．胸部CTでは右S6に，ブラに接する5 cmの腫瘤が胸壁に浸潤していた．気管支鏡下生検にて診断がつかず，原発性肺癌の胸壁浸潤を疑い開胸した．術中針生検にて扁平上皮癌と診断され右下葉切除，胸壁合併切除，及び縦隔リンパ節郭清を施行した．病理所見では腫瘍は低分化型扁平上皮癌と診断され，ほぼ胸壁に限局していた．弾性線維染色では臓側胸膜の弾力膜を超えた肺実質内部への浸潤をほとんど認めなかった．以上より原発性肺癌とは考えにくく，胸壁への転移性あるいは胸壁原発の扁平上皮癌が疑われた．術後他臓器の検索を行い，18F-fluoro-2-deoxy-glucose positron-emission tomographic scanにて直腸肛門部に強い集積を認めたが，切除にて膿瘍と診断された．さらに上部及び下部消化管，耳鼻科領域などの精査も行ったが原発巣と考えられる病変は発見できなかった．結語．術前原発性肺癌の胸壁浸潤を疑い切除したところ，転移性あるいは原発性の胸壁扁平上皮癌の肺浸潤と考えられた．

Acquired deformities of the chest wall are malformations, which develop due to non-congenital causative factors. Based on etiology, three major categories of acquired chest wall malformations can be distinguished. (1) Primary disease of the chest wall itself can cause deformation of the chest wall. This includes tumors and infections affecting the chest wall with subsequent development of chest wall deformation. (2) The largest group of acquired chest wall deformities are iatrogenic in nature and occur as a result of previous surgical intervention to the chest wall, seen as acquired restrictive thoracic dystrophy or acquired Jeune’s syndrome in young patients following open correction of pectus excavatum deformity. Iatrogenic chest wall deformities may also develop following rip graft harvesting or failed closure of thoracotomies. (3) Post-traumatic deformities are a result of direct or indirect trauma to the torso. This chapter is aimed to provide a comprehensive overview of the spectrum of acquired chest wall deformities and to discuss their pathophysiology, diagnosis and treatment.

症例は57歳, 男性. 1995年に鼻咽頭癌にて腫瘍摘出術および放射線治療を施行後, 1997年より2004年までに左第7肋骨, 左壁側胸膜の転移に対して手術療法, 胸椎 (Th7, 8), 左大腿骨骨幹部, 腹部傍大動脈部の転移に対して放射線療法を行い, 間歇的に化学療法を施行されてきた. 2004年7月ごろより左胸側背部痛の出現を認めたため胸部CTを施行したところ, 左第7肋骨の前側方の切除断端部位と左第8肋骨背側部から第7肋間の傍脊柱領域にかけての壁側胸膜に不整な肥厚像を認めた. MRIとthin slice CTで傍脊柱領域の胸膜肥厚は左第7,8胸椎椎間孔に伸展し脊柱管内で腫瘤を形成していた. 後方からの左片側椎弓切除と側方開胸下に各腫瘍を切除し, いずれも鼻咽頭癌の転移の診断を得た. 傍脊柱領域の胸壁腫瘍は, 神経原性腫瘍以外でも, MRIやthin slice CTにより椎間孔や脊柱管内の検索を行う必要があると考えられた.

Chondromyxoid fibromas are benign tumors which are found most frequently in the metaphyses of long bones. They comprise less than 1% of primary bone neoplasms and display a hypermetabolic appearance on PET imaging. Oftentimes, they are misdiagnosed as chondrosarcomas and are excised due to concern for malignancy. We present a case of a condromyxoid fibroma originating from the second rib of a 15-year-old girl.

Primary chest wall tumors are uncommon. Common soft tissue neoplasms and non-neoplastic chest wall masses include peripheral nerve tumors, lipomas, liposarcomas, lymphoma, haemangiomas, elastofibromas, metastases from distant tumors, desmoids tumors, infectious mass lesions, and malignant fibrous histiocytoma. Lymphoma comprises 2% of primary chest wall tumors. Treatment of these tumors is unclear. We are presenting a case of 65 years old male who presented to us with primary chest wall lymphoma on right lateral chest wall. Resection followed by adjuvant chemotherapy provided optimal disease control in our case. Key message Isolated chest wall lymphoma is a rare entity, treatment is also uncertain. Resection followed by adjuvant chemotherapy may be the appropriate management.

We present a case report of a 65-year-old woman who underwent resection of a chest wall tumor. In contrast with computed tomography, the tumor exhibited hypervascularity and was fed from the 9th intercostals artery. Histologically, the tumor was diagnosed as a cellular variant of solitary fibrous tumor of the pleura, with branching “staghorn” vessels and hypervascularity. The tumor thus resembled a chest wall hemangiopericytoma.

Full thickness chest wall defects result when a chest wall tumor resection is necessary. The feasibility of a reconstruction is sometimes unfamiliar to the oncologist or thoracic surgeon; this can be the reason for refusing the possibility of surgical resection or inappropriate coverage of the defect. Our experiences over the last 7 years in collaboration between plastic the thoracic surgical services, shows that it is generally possible to utilize a myocutaneous flap for reconstruction of even extensive full thickness chest wall defects. The reconstruction of any full thickness chest wall defect after tumor resection by myocutaneous flaps is almost always possible with low mortality, acceptable morbidity and good results, mechanically and aesthetically. The experience with the different reconstruction techniques clearly shows the preference for the latissimus dorsi myocutaneous flap, but also emphazises that the other kinds of reconstruction must be kept in mind for special indications.

Hemangiomas affecting the chest wall are rare. The literature suggests sporadic cases of these chest wall tumors. We report in this paper a very rare subtype of intercostal hemangiomas (mixed subtype). We describe the physical, clinical, imaging and pathology findings as well as the surgical therapeuthic procedure. In addition we review the literature for similar cases reported.

Pleomorphic liposarcoma (PLS) is a rare high-grade sarcoma that originates commonly in the extremities and on the retroperitoneum. PLS originating in the chest wall is infrequently reported in literature. One such case in an elderly man who presented with a giant anterior chest wall tumor is reported herein. The computed tomography scan of the chest helped in delineating the mass. The diagnosis was confirmed on histopathology. The tumor was managed with a radical excision with reconstruction. The patient underwent follow-up for 1 year during which no local recurrence or metastasis was found. PLS should be considered in the differential diagnosis of primary chest wall tumor.

This chapter covers the resection of sternal tumors. The indications for surgery as well as the outcomes of surgical treatment are discussed in detail. The chapter also provides detailed descriptions and illustrations of surgical techniques of sternal resection as well as reconstruction of both skeletal and soft tissue defects.