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Published on: September 13, 2019
Massive leiomyosarcoma of the chest wall in a young child
Insights
A rare, large primary chest wall leiomyosarcoma was successfully treated with surgical resection, radiotherapy, and chemotherapy. This case highlights effective management of extensive thoracic tumors, achieving a tumor-free outcome.
Area of Science:
- Oncology
- Thoracic Surgery
- Medical Imaging
Background:
- Primary leiomyosarcomas of the chest wall are rare soft tissue tumors.
- Early detection and diagnosis are crucial for effective treatment.
Observation:
- A massive chest wall tumor with mediastinal involvement was identified in an asymptomatic patient.
- Imaging revealed a large mass requiring extensive surgical intervention.
Findings:
- Histopathological examination confirmed leiomyosarcoma.
- Successful wide en bloc excision of the chest wall, including ribs and lung tissue, was performed.
- Post-operative radiotherapy and chemotherapy were administered.
Implications:
- This case demonstrates the feasibility of aggressive surgical management for large chest wall leiomyosarcomas.
- Multimodal treatment, including surgery, radiation, and chemotherapy, can lead to favorable outcomes.
- Further research into optimal treatment strategies for rare thoracic sarcomas is warranted.
Abstract:
An unusual instance of a very large primary leimyosarcoma of the chest wall is presented. It was asymptomatic but a swelling had been noted between the left clavicle and nipple by the parents. Chest x-ray showed a massive tumor with mediastinal involvement. Preliminary biopsy indicated a leiomyosarcoma. Wide an bloc excision of the chest wall was done, including much of the 1, 2, and 3 ribs and a piece of lung. The defect was closed with Marlex mesh and covered with a U-shaped flap of pectoralis major muscle and skin. There were 4000 rads of radiotherapy plus 15 mo of chemotherapy added. To date, she remains clinically well and apparently tumor-free.
