Study on the Effect of MRI in the Diagnosis of Benign and Malignant Thoracic Tumors

In order to investigate the effectiveness and accuracy of magnetic resonance imaging (MRI) in the diagnosis of benign and malignant thoracic tumors, the research retrospectively selected 80 patients with thoracic tumors admitted from May 2019 to May 2020 as the study subject and all patients were underwent MRI detection. Using pathological diagnostic results as the gold standard, the research analyzed the detection of benign and malignant thoracic tumors by MRI, as well as the diagnostic sensitivity and specificity. After pathological diagnosis, there were 35 malignant tumors and 45 benign tumors. 41 cases of malignant tumors and 39 cases of benign tumors were diagnosed by MRI, with a diagnostic sensitivity of 80.00%, a diagnostic specificity of 71.11%, and a diagnostic compliance rate of 75.00%. In the MRI diagnosis of tumors in different parts of the chest, the diagnostic sensitivity for lung tumors, mediastinal tumors, chest wall tumors, and esophageal tumors was 83.33%, 71.43%, 83.33%, 75.00%, and 87.50%, respectively, and the specificity was 66.67%, 77.78%, 57.14%, 50.00%, and 91.67% according to and breast tumors, respectively. And the accuracy was 73.33%, 75.00%, 69.23, 62.50%, and 90.00%, respectively, with the highest diagnostic sensitivity, specificity, and accuracy for breast tumors. MRI has a good effect on the diagnosis of benign and malignant thoracic tumors and has a high diagnostic value, which is helpful to identify the location, nature, source, and lesion scope of the tumor. It is safe and worthy of promotion.

Forms of sternal reconstruction in oncology

INTRODUCTION. Chest wall tumors represent a variety of morphological forms and variants of lesions. According to different authors, primary malignant tumors of the chest wall account for 0.2–2 % of all malignant neoplasms. Of them, soft tissue sarcomas constitute about 45 %. Metastatic tumors of the chest wall occur much more frequently and most commonly develop from malignant tumors of the mammary, prostate and thyroid glands, lungs, kidneys and ovaries.MATERIALS AND METHODS. The standard of the treatment of primary and metastatic tumors of the chest wall is combination or comprehensive therapy. In some cases, preoperative care allows to create a more favorable environment for performing surgical treatment being considered the best option for chest wall tumors. The choice of a technique for the replacement of the post-resection chest wall defect is of special importance to preserve the physiological chest volume, to restore chest rigidity, to prevent paradoxical respiration and to seal the pleural cavity.RESULTS. There are different surgical techniques for skeleton reconstruction. A wide range of materials used for a skeleton reconstruction include bone tissues obtained from patient’s own body (bone autoplasty, autografts), polymeric mesh (polypropylene, polytetrafluoroethylene (Gore-Tex), bone cement (polymethyl methacrylate), stainless steel and titanium constructions as well as titanium bars and rib clips (STRATOS). In spite of a large number of techniques for sternal reconstruction described in the literature, searching for new materials and ways of their usage appears relevant.CONCLUSION. Our clinical case studies demonstrate that modern reconstructive techniques combined with careful surgical planning allow to perform radical surgery with a successful outcome preventing serious postoperative complications.

Exostosis of Rib: Case Report of an Extremely Rare Giant Osteochondroma at an Unusual Site, Radiopathological Correlation with Brief Review of Literature

Osteochondromas are common benign tumors developing as an abnormal bony growth in the metaphyseal region. Being more of a developmental anomaly rather than a true neoplasm, they are usually found around the growth plates of long bones such as the knee, hip, and shoulder. These are typically managed conservatively if they are asymptomatic; however, they require excision in symptomatic patients. A 38-year-old woman presented with a huge swelling causing disfigurement measuring 16 × 16 cm on the left side of chest wall. Radiographs and computed tomography scan showed a bony outgrowth at costochondral junction of second rib which was in continuity with the periosteum. Excision via mediastinal sternotomy and left thoracotomy was done. Histopathological features corroborated with the radiological diagnosis of osteochondroma. Osteochondroma should be considered in the differential diagnosis of chest wall tumors. Rib is an extremely rare site of presentation. The cartilaginous cap becomes fully ossified and is lost in longstanding lesions. Huge tumors at such a location can cause irritation of adjacent viscera which can lead to pleural effusion or hemothorax; therefore, a cautious and logical approach to diagnosis is warranted for appropriate therapeutic management.

A Modified Reconstruction Technique of Chest Wall after Radical Resection of Chondrosarcoma Underlying the Breast

Chest wall tumors are uncommon and include a variety of Cartilaginous, bony, and soft tissue lesions. The clinical presentation varies from asymptomatic to chest pain or ulcerating chest mass. Retro mammary chondrosarcoma of the chest wall can present as a painless breast mass and may be mistaken for a breast tumor. A careful clinical examination and relevant investigations are a cornerstone to plan an appropriate surgical procedure.

Resection and postoperative radiation therapy for desmoid fibromatosis of the chest wall in a young woman

Background Surgery is an effective treatment for desmoid fibromatosis, but it may be difficult, depending on the location or local spread of the tumor, and the decision to perform surgery must be made carefully. We herein report a case of desmoid fibromatosis of the chest wall in a young woman suspected of having invasion to the 1st, 2nd and 3rd ribs. Case presentation A 35-year-old woman had been aware of dry cough and right chest pain, so she was referred to our hospital. Chest computed tomography showed a localized pleural tumor mainly at the first rib. Magnetic resonance imaging revealed a 75 × 65 × 27-mm tumor with a smooth surface, with partial contact from the first rib to third rib and partial extension to the 1st intercostal space. The tumor showed growth in the two months after the first visit, so resection was performed. The tumor was completely resected, and adjuvant radiation therapy (50 Gy) was performed for the small margin. The pathological diagnosis was desmoid fibromatosis. The postoperative course has been uneventful, without recurrence at 14 months after surgery. Conclusions In chest wall tumors located ventral of the pulmonary apex, we suggest that a combination of the Grunenwald method and Masaoka anterior approach may be a useful option. In cases where margin is not enough, adjuvant radiation therapy should be considered.

Reconstruction methods in chest wall resections

Chest wall defects generally result from resection of primary chest wall tumors, locally-invasive malignancies, or metastatic lesions. After an R0 chest wall resection, first skeletal stability must be established with prosthetic or bioprosthetic materials, or a combination of both. Regardless of the technique used to establish skeletal stability, soft tissue coverage of the prosthesis is necessary. The primary goals of all chest wall reconstructions are to obliterate dead space, restore chest wall rigidity, preserve pulmonary mechanic, protect intrathoracic organs and provide soft tissue coverage. In this article, our aim is to review the basic principles and indications of the chest wall resection and reconstruction, preoperative evaluation of patients, and the materials and methods used for the reconstruction.