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Chest wall masses in children.

E S Golladay, J A Hale, D L Mollitt

    Southern Medical Journal
    |March 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    A hard, fixed chest wall mass in children is often benign, despite initial concerns for malignancy. Early diagnosis and a graded treatment approach improve survival and minimize deformity in pediatric patients.

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    Area of Science:

    • Pediatric Oncology
    • Thoracic Surgery
    • Diagnostic Imaging

    Background:

    • Hard, fixed chest wall masses in children are frequently presumed malignant.
    • Malignancy is often suspected based on physical and radiographic findings.

    Purpose of the Study:

    • To evaluate the nature of hard, fixed chest wall masses in pediatric patients.
    • To assess the diagnostic challenges and treatment outcomes for these lesions.

    Main Methods:

    • Retrospective review of 24 pediatric cases with hard, fixed chest wall masses.
    • Analysis of diagnostic methods including physical examination, radiography, and histology.
    • Evaluation of treatment strategies and patient outcomes.

    Main Results:

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    • Only 33% (8 of 24) of evaluated lesions were malignant.
    • Six of eight children with malignant masses died from the disease.
    • Benign and malignant lesions were often indistinguishable by initial examination; histologic diagnosis was challenging.
    • Seven masses resulted from indolent infections, highlighting the need for cultures.
    • Small lesions were amenable to complete excision with minimal deformity.

    Conclusions:

    • The majority of hard, fixed chest wall masses in children are benign.
    • A graded diagnostic and treatment approach, including biopsy and cultures, is crucial.
    • Timely intervention with surgery, irradiation, and chemotherapy improves survival rates for malignant cases.
    • Surgical reconstruction with mesh or flap coverage effectively manages defects after radical operations.
    • This approach enhances survival and minimizes deformity in pediatric chest wall lesions.