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Vol. 41. Issue 1.
Pages 53-56 (January 2005)
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Vol. 41. Issue 1.
Pages 53-56 (January 2005)
Case Reports
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Vascular Tumors Arising in the Chest Wall: 25 Years' Experience
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A. Santiago Recuerdaa,
Corresponding author
asantiago@mi.madritel.es/
anasansecu@hotmail.com

Correspondence: Dra. A Santiago Recuerda. Isla de Arosa, 8, 14B. 28035 Madrid. España
, M.E. Corpa Rodríguezb, J. García-Sánchez Girónb, P. Díaz-Agero Álvarezb, J.C. Vázquez Pelillob, M. Casillas Pajuelob
a Servicio de Neumología, Hospital Universitario La Paz, Madrid, Spain
b Servicio de Cirugía Torácica, Hospital Universitario La Paz, Madrid, Spain
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Seventy-three interventions for chest wall tumors were performed at our hospital from 1978 through 2003. Six (8.2%) tumors were vascular. Four of them were soft tissue tumors, and two involved bone. The histologic diagnoses were hemangioendothelioma (1), low-grade angiosarcoma (1), and hemangioma (4). The diagnosis was established after surgery in all cases except one that had been previously diagnosed during an attempted resection before the patient came to our hospital.

Fine needle aspiration carried out in 4 patients was inconclusive in all cases. Complete tumor resection with a margin greater than 3 cm was performed in each patient. Embolization followed by ligation of the intercostal vessels was performed prior to tumor resection in 1 patient with arteriovenous fistula and diffuse angiomatosis. Chest wall reconstruction after tumor removal was carried out using autologous tissues except in 1 case in which a Marlex mesh (CR Bard Inc., Burlington, USA) and a metallic prosthesis was inserted to prevent deformity in the lower costal arch.

All patients have been followed and have survived with no evidence of recurrence after follow up ranging from 2 to 25 years.

Key Words:
Vascular tumors
Chest wall
Hemangioma
Angiosarcoma
Hemangioendothelioma

En el período de 1978 a 2003 realizamos 73 intervenciones en tumores de la pared del tórax, de los cuales 6 eran tumores vasculares, un 8,2%. Cuatro eran tumores de partes blandas y 2 tenían afectación ósea. El diagnóstico histológico fue de 4 hemangiomas, un hemangioendotelioma y un angiosarcoma de bajo grado. En todos el diagnóstico se estableció tras la cirugía, excepto en un caso que había sido diagnosti-cado previamente en un intento de resección antes de llegar a nuestro servicio.

A 4 enfermos se les realizó una punción-aspiración con aguja fina, que no fue concluyente en ningún caso. Se practicó resección completa del tumor en todos los pacientes, con un margen superior a 3 cm. En un enfermo con fístula arte-riovenosa y angiomatosis difusa se practicó embolización con posterior ligadura quirúrgica de los vasos intercostales antes de la resección tumoral. La reconstrucción parietal del defecto tras la extirpación del tumor se llevó a cabo con teji-dos propios, excepto en un caso en que utilizamos placa de Marlex y prótesis metálica para evitar la deformidad de la arcada costal inferior.

Hemos realizado seguimiento de todos los enfermos, que en la actualidad están vivos y sin signos de recidiva, entre 2 y 25 años tras la cirugía.

Palabras clave:
Tumores vasculares
Pared torácica
Hemangioma
Angiosarcoma
Hemangioendotelioma
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REFERENCES
[1]
RM King, PC Pairolero, VF Trastek, JM Piehler, WS Payne, PE Bernatz.
Primary chest wall tumors: factors affecting survival.
Ann Thorac Surg., 41 (1986), pp. 597-601
[2]
GL Walsh, BM Davis, SG Swisher, AA Vaporciyan, WR Smythe, K Willis-Merriman, et al.
A single-institutional, multidisciplinary approach to primary sarcomas involving the chest wall requiring full thickness resections.
J Thorac Cardiovasc Surg., 121 (2001), pp. 48-60
[3]
C Alexiou, CA Clelland, D Robinson, WE Morgan.
Primary angiosarcomas of the chest wall and pleura.
Eur J Cardiothorac Surg., 14 (1998), pp. 523-526
[4]
N Naka, M Ohsawa, Y Tomita, H Kanno, A Uchida, K Aozasa.
Angiosarcoma in Japan. A review of 99 cases.
Cancer, 75 (1995), pp. 989-996
[5]
R Arrabal, A Fernández, C Pagés, A Benítez, JL Fernández.
Tumores primitivos de pared torácica (1991-1994).
Arch Bronconeumol., 32 (1996), pp. 384-387
[6]
WL Watson, WD McCarty.
Blood and lymph vessel tumor. A report of 1056 cases.
Surg Ginecol Obstet., 71 (1940), pp. 569-588
[7]
Y Yonehara, T Nakatsuka, I Ichioka, T Takato, S Matsumoto, A Yamada.
Intramuscular haemangioma of the anterior chest wall.
Br J Plast Surg., 53 (2000), pp. 257-259
[8]
C Fletcher.
Vascular tumours.
Pathology and genetics of tumours of soft tissue and bone, pp. 155-178
[9]
CD Fletcher.
Vascular tumors: an update with emphasis on the diagnosis of angiosarcoma and borderline vascular neoplasms.
Monogr Pathol., 38 (1996), pp. 181-206
[10]
DC Dahlin.
Bone tumors: general aspects and data on 6221 cases, pp. 137-148
[11]
JI de Granda, F Baquero, JR Ramírez.
Hemangioma costal: un diagnóstico infrecuente.
Arch Bronconeumol, 38 (2002), pp. 154-155
[12]
JL Scott.
Hemangiomata in skeletal muscle.
Br J Surg., 44 (1957), pp. 496-501
[13]
K Shimizu, Y Yamashita, J Hihara, Y Seto, T Toge.
Cavernous hemangioma of the rib.
Ann Thorac Surg., 74 (2002), pp. 932-934
[14]
AJ Howat, PE Campbell.
Angiomatosis: a vascular malformation of infancy and childhood. Report of 17 cases.
Pathology, 19 (1987), pp. 377-382
[15]
DE Maziak, FM Shamji, R Peterson, DG Perkins.
Angiosarcoma of the chest wall.
Ann Thorac Surg., 67 (1999), pp. 839-841
[16]
JC Maddox, HL Evans.
Angiosarcoma of skin and soft tissues.
Cancer, 48 (1981), pp. 1907-1921
Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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