Chest Wall Tumors and Sarcomas
The chest wall is the bone-and-tissue framework—including the spine, sternum, and ribs—that forms a cage around vital organs such as the heart and lungs. Many types of tumors can grow in this structure. Some are primary tumors, which originate in the chest wall and can be either benign or malignant; some are secondary tumors, which metastasize to the chest wall from another site in the body and are almost always malignant.
Malignant chest wall tumors include many types of sarcoma, which is a category of cancerous tumor that can form in bones, soft tissues, and cartilage anywhere in the body. Symptoms of chest wall sarcomas vary with the tumor’s classification and severity, and could include difficulty breathing as well as pain and swelling surrounding the tumor.
Types of Chest Wall Sarcomas
The following types of sarcomas could grow in the chest wall:
- Chondrosarcoma, which forms in cartilage, and is the most common type of primary chest wall bone cancer. It usually presents as a slowly enlarging painful mass
- Osteosarcoma, which forms in bone, typically during a period of accelerated growth, such as adolescence. It typically presents as a rapidly enlarging painful mass
- Ewing’s sarcoma, which forms in bone, and most often affects children and young adults. It usually presents as a painful mass with systemic symptoms (fever, malaise)
- Plasmacytoma, which arises from plasma cells and is an isolated form of multiple myeloma. Patients often present with pain but no mass. This is one of the few chest wall tumors in which surgery is not the primary treatment modality
- Malignant fibrous histiocytoma, which is the most common soft tissue sarcoma and often occurs in adults. These usually present as a slowly growing painless mass
- Rhabdomyosarcoma, which forms in striated muscle, and most often affects children and young adults. These usually present as a rapidly growing painless mass
Treatments for Chest Wall Tumors
The process of diagnosing a chest wall tumor typically begins with a physical exam, followed by an imaging test, such as an X-Ray, CT scan, or MRI scan. Additional information about the tumor will be determined though a biopsy, a procedure in which a tissue sample is removed from the affected area for further study.
Treatment can vary based on factors such as the type of tumor and the stage of its progression. Surgical resection is the mainstay of treatment for most early stage chest wall tumors. Additional treatment can include radiotherapy (the use of radiation to kill cancer cells) and/or chemotherapy (the use of drugs to kill cancer cells).
Here at Mount Sinai, your thoracic surgeon will coordinate a team of specialists in the management of this disease. Our treatment philosophy is to remove all of the tumor, while preserving respiratory function and protecting the underlying chest structures (heart, lungs, great vessels). Our goal is to cure the disease with minimal to no decrease on quality of life.