Retrospective study of chest wall tumors at a cancer hospital in Nepal

Primary and metastatic tumors of both soft tissues and bony skeleton, and primary tumors of adjacent organs invading the chest wall constitute chest wall tumors. A retrospective review of all the patients with chest wall tumors was done at BP Koirala Memorial Cancer Hospital (BPKMCH). Primary tumors of breast were excluded. Surgical treatment consisted of wide local excision (WLE). Chest wall reconstruction, if needed, was achieved by a muscular flap +/- prolene mesh +/- omental transposition. Thirty one patients were treated in the period from October 1999 to October 2003. Age of the patients varied from 3 years to 72 years (mean age--38 years). Presenting complaint was mass in 96.8% and pain in 48.4% cases. The mass was 5 cm or less in 34.4%, from 5 to 10 cm in 32.3%, and more than 10 cm in 32.3% cases. The lesions were located in sternal region, anterior, lateral, posterior, and vertebral chest wall in 6.5%, 32.3%, 41.9%, 16.1% and 3.2% respectively. WLE was done in 29 cases. Chest wall reconstruction using both muscular flaps and prolene mesh (15x15 cm) was done in 8 cases. In three of them, where concomitant wedge resection of the lung was done, omental transposition was added. In rest of the cases, primary closure, muscular/myocutaneous flap or skin grafting was done. Minor complications were observed in 31.0% cases, which were managed conservatively. Two patients received adjuvant radiotherapy and four patients--adjuvant chemotherapy. There were no postoperative deaths. The rate of malignancy was 48.4%.