[Primary and secondary chest wall tumors from the pathologist's viewpoint]

Area of Science:

• Oncology
• Pathology
• Thoracic Surgery

Context:

• Chest wall tumors encompass both primary bone lesions and rare soft tissue neoplasms.
• Common bone tumors include fibrous dysplasia, metastases, and chondrosarcoma.
• Primary soft tissue tumors of the chest wall are infrequent, with exceptions like Askin tumor, Abrikosoff tumor, elastofibroma dorsi, and desmoid tumors.

Purpose:

• To review the common and rare tumors affecting the chest wall.
• To highlight the diagnostic challenges in classifying undifferentiated sarcomas and thoracic metastases.
• To emphasize the necessity of multidisciplinary collaboration for accurate histogenetic classification.

Summary:

• Fibrous dysplasia (20%), metastases (16%), and chondrosarcoma (11%) are the most frequent primary bone tumors of the chest wall.
• Primary soft tissue lesions of the chest wall are rare, with notable exceptions including Askin tumor, Abrikosoff tumor, elastofibroma dorsi, and desmoid tumors.
• Accurate histogenetic classification of undifferentiated sarcomas and thoracic metastases (e.g., prostatic carcinomas, mesotheliomas) necessitates close cooperation between surgeons and pathologists, supported by modern immunohistochemical investigations.

Impact:

• Provides a concise overview of chest wall tumor epidemiology.
• Underscores the importance of advanced diagnostic techniques and interdisciplinary communication in managing complex thoracic malignancies.
• Aids clinicians in recognizing and differentiating various chest wall tumor types, improving patient care and treatment strategies.