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Chest Wall Tumours

Cardio-thoracic SurgeryClinical OncologyPlastic Surgery

Complete resection of a chest wall tumour may require the removal of the overlying skin, muscle layers, and ribs and may necessitate reconstruction of the chest wall using autologous tissue or prosthetic materials to preserve its shape and function.

Symptoms

Chest palpable mass or swelling
Chest pain or tenderness: Especially prominent when a bone is involved or the tumour invades the periosteum.
Respiratory compromise: Large tumours or unreconstructed defects may reduce chest expansion, causing dyspnea.
Systemic signs (rare): Fever or weight loss may indicate malignancy or secondary infection.

Causes

Chest wall tumours arise from the structures of the thoracic cage—including skin, muscle, ribs and cartilage—and may be primary (originating in soft tissue or bone, e.g., sarcomas) or secondary (direct invasion or metastasis from nearby organs such as lung or breast cancers).

Primary chest wall tumours	Soft tissue sarcomas: Liposarcoma, leiomyosarcoma, fibrosarcoma. Bone/cartilage sarcomas: Osteosarcoma, chondrosarcoma, rhabdomyosarcoma.
Secondary chest wall tumors	Direct invasion: From primary lung carcinoma or malignant mesothelioma. Metastases: From breast carcinoma or other distant neoplasms to ribs or soft tissue.

Risk Factors

Prior thoracic radiotherapy: Increased risk of radiation-induced sarcomas.
Chronic trauma or inflammation: Repeated injury or scarring can predispose to malignant transformation.
Genetic syndromes: Li-Fraumeni syndrome, hereditary multiple exostoses.
History of malignancy: Previous lung, breast or other cancers.

Diagnosis

Clinical examination	Inspection for skin changes or ulceration; palpation for size, consistency and mobility.
Imaging	X-ray: Initial detection of rib destruction or calcifications. CT scan: Defines tumor size, bone involvement and relationship to adjacent structures. MRI: Superior soft-tissue contrast; evaluates muscle, nerve or vascular invasion. PET-CT: Assesses metabolic activity and distant metastases.
Histopathology	Core-needle biopsy or excisional biopsy: Determines benign vs. malignant nature, histologic subtype and grade; may include molecular profiling.

Treatments

Chest wall tumours are typically managed with individualised treatment plans developed jointly by specialist teams including clinical oncology, cardiothoracic surgery, and plastic & reconstructive surgery.

Surgical Resection

Complete resection: May need to remove a length of healthy tissue around the tumour to ensure a clean resection margin.
Reconstruction: Restore the shape and function of the chest wall with autologous tissue or artificial materials, depending on the size of the defect.

May need musculocutaneous flaps (e.g., latissimus dorsi), prosthetic meshes (e.g., PTFE) or metallic materials.
May need rigid support (e.g., rib prosthesis) to restore structural stability.

Radiotherapy

Neoadjuvant: Shrinks large or locally invasive tumours before operation to increase the chance of complete resection.
Adjuvant: Reduces local recurrence risk, especially when margins are close or positive;
Palliative: for unresectable tumours.

Chemotherapy

Systemic regimens: Multi-agent protocols (e.g., ifosfamide plus doxorubicin) for high-grade sarcomas or metastatic disease.
Targeted/Immunotherapy: Considered in tumours with specific molecular alterations (e.g., PD-1 inhibitors in sarcoma subtypes).

FAQ

Proper reconstruction generally restores lung function satisfactorily; early respiratory physiotherapy minimizes functional deficits.

Strict intraoperative sterility, perioperative antibiotic prophylaxis, and close postoperative wound monitoring reduce infection rates to <5%.

Potential risks include haemorrhage, empyema, implant migration/infection, flap necrosis and delayed wound healing; hospital stay is typically 2–3 weeks, with full recovery over 3–6 months.

Cancer Centres

We provide a variety of treatment options for chest wall tumours, including surgery, chemotherapy, targeted therapy, immunotherapy, radiation therapy, and traditional Chinese medicine. Our multidisciplinary team of specialists will tailor the best treatment plan for each patient, providing comprehensive and holistic care to ensure you receive the best possible outcomes and support throughout your cancer treatment journey.

Chest Wall Tumours

Symptoms

Causes

Risk Factors

Diagnosis

Treatments

FAQ

Cancer Centres

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