A multidisciplinary approach to giant soft tissue sarcoma of the chest wall: A case report. (2016)

• Record Type: Journal Article
• Authors: Davis, Catherine H.; Yammine, Halim; Khaitan, Puja G.; Chan, Edward Y.; Kim, Min P.
• Is Part Of: International journal of surgery case reports. Volume 28(2016)
• Page Start: 211
• Page End: 213
• Publication Date: 2016
• Subjects: Thoracic surgery -- Soft tissue sarcoma -- Chest wall tumor -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2016.10.002
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Chest wall sarcomas most commonly present as painless slow growing masses. Resection is often precarious due to involvement of important structures. The multidisciplinary approach is crucial for the optimal management of this tumor. Abstract: Introduction: Soft tissue sarcomas of the chest wall are exceptionally rare entities that present as painless slow growing masses. Resection is often precarious due to involvement of vital structures, and patients are left with large chest wall defects postoperatively requiring extensive reconstruction. Presentation of case: We present a case report of a 29 year-old man who presented with a giant soft tissue sarcoma of the chest that had been growing slowly for one year prior to presentation. The patient had a biopsy that was positive for sarcoma, and PET CT demonstrated a large lobulated mass in the left chest wall with an SUV of 6.7. He received 50 Gy of radiation therapy; however, the mass continued to grow in size. He subsequently underwent an en-bloc resection of the mass with latissimus and serratus muscle primary reconstruction. Final pathology showed a 27 cm high-grade fibrosarcoma with prominent myxoid component. To our knowledge, this is the largest soft tissue sarcoma of the chest wall reported in the literature. Postoperatively, the patient received 6 cycles of adjuvant chemotherapy. Discussion: Surgery is the mainstay of treatment, and chemotherapy and radiation are used in specific circumstances. Risk of recurrence is dependent on many factors, including histologic subtype, grade, and size of tumor. Long term surveillance with physical exam and imaging is recommended. Conclusion: We feel that the multidisciplinary approach is crucial for optimal management of large soft tissue sarcomas. We recommend this approach to all patients with chest wall sarcomas.