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Vol. 32. Issue 8.
Pages 384-387 (October 1996)
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Vol. 32. Issue 8.
Pages 384-387 (October 1996)
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Tumores primitivos de pared torácica (1991-1994)
Primitive tumors of the chest wall (1991-1994)
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R. Arrabal Sánchez*, A. Fernández de Rota, C. Pagés Navarrete, A. Benítez Doménech, J.L. Fernández Bermúdez
Servicio de Cirugía Torácica. Hospital Regional Carlos Haya. Málaga
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En el período entre 1991 y 1994 se han realizado en nuestro servicio 582 intervenciones, de las cuales 19 han correspondido a tumores primitivos de pared torácica (3,26%). Analizamos edad, sexo, clínica, características radiológicas, diagnóstico, terapéutica y evolución.

Se dividen en 10 tumores benignos y nueve malignos. La clínica más frecuente fue la presencia de dolor y/o tumor. El diagnóstico preoperatorio sólo se obtuvo en 2 casos.

A no ser en casos de claros signos radiológicos y macroscópicos de benignidad, se realizó exéresis amplia de la pared torácica, a veces con resección de estructuras adyacentes. El defecto se reparó directamente en 12 casos y en los restantes se cubrió el defecto con prótesis de diversos materiales y/o plastias musculares.

El tumor más frecuente fue el condrosarcoma (3 casos), en dos ocasiones, osteoblastoma y osteocondroma y solamente en un caso los demás tumores (plasmocitoma, condroma, displasia fibrosa, granuloma eosinófilo, osteosarcoma, tumor de Ewing, sarcoma epiteloide, fibrosarcoma, hemangioma, neurilemoma benigno, tumor desmoide y liposarcoma).

Dos pacientes con condrosarcoma fueron intervenidos por presentar recidiva y el tumor de Ewing también lo hizo. Hubo 2 fallecidos: uno con condrosarcoma y otro con tumor de Ewing.

Concluimos que: 1) los tumores de pared torácica son tumores poco frecuentes; 2) el tratamiento es la exéresis amplia, que a menudo requiere prótesis, y 3) el más frecuente es el condrosarcoma, de mala evolución en los casos objeto de nuestro estudio.

Palabras clave:
Tumor pared torácica
Resección pared torácica

Between 1991 and 1994, 582 operations were performed in our service; 19 (3.26%) were on primitive tumors of the chest wall. We analyze the data for these patients, including age, sex, clinical findings, chest images, diagnoses, therapy and course.

Ten tumors were benign and 9 were malignant. The most frequent clinical findings were pain and/or tumor. Diagnosis was achieved before surgery in only 2 cases.

Except when there are clear macroscopic and X-ray signs that the tumor is benign, we performed broad exeresis of the chest wall, sometimes also resecting adjacent structures. The defect was repaired directly in 12 cases. The defects were covered by prostheses and/or muscle plasty in the remaining patients.

The most frequent tumor was chondrosarcoma (3 cases), followed by 2 cases of osteoblastoma and osteochondroma. Only 1 each of the following tumors were found: plasmocytoma, chondroma, fibrous dysplasia, eosinophilic granuloma, osteosarcoma, Ewing's tumor, epithelioid sarcoma, fibrosarcoma, hemangioma, benign neurilemoma, desmoid tumor and liposarcoma.

Two patients with chondrosarcoma were operated on for recurrences and there was also recurrence in the patient with Ewing's tumor.

We conclude that: 1) chest wall tumors are infrequent, 2) radical exeresis is the treatment of choice and prosthesis is often necessary, and 3) chondrosarcoma, with poor outcome in our patients, is the most frequent tumor.

Key words:
Chest wall tumor
Chest wall resection
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Copyright © 1996. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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