Clavicular Malignancies: A Borderline Surgical Management.

Area of Science:

• Orthopedic Oncology
• Thoracic Surgery
• Surgical Reconstruction

Background:

• Primary clavicular tumors constitute approximately 1% of all bone cancers.
• Their rarity leads to unfamiliarity among clinicians regarding diagnosis, classification, treatment, and prognosis.
• Malignant clavicular tumors encompass primary, secondary, and invasive neighboring malignancies.

Purpose of the Study:

• To synthesize anatomical and physiopathological aspects of primary clavicular tumors.
• To review the limited available therapeutic surgical options for these rare tumors.
• To highlight the importance of multidisciplinary teams in managing complex cases with chest wall involvement.

Main Methods:

• Literature synthesis focusing on anatomical considerations, pathophysiology, and surgical management.
• Review of current diagnostic and classification approaches for clavicular tumors.
• Analysis of reconstruction techniques following claviculectomy and chest wall resection.

Main Results:

• Clavicle reconstruction is logically considered for function preservation but requires further study.
• Reconstruction techniques are complex due to surrounding anatomical structures.
• Multidisciplinary teams are crucial for optimal surgical management, especially with chest wall defects.

Conclusions:

• Accurate diagnosis and preoperative planning are essential to minimize complications.
• Post-resection reconstruction is vital for scapular girdle biomechanics, neurovascular protection, pain reduction, and shoulder aesthetics.
• Chest wall resection and reconstruction techniques vary based on defect extent, influencing material and method choices.