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Chest Wall Tumors

By Anne S. Tsao, MD, Director, Mesothelioma Program; Director, Thoracic Chemo-radiation Program, Department of Thoracic/Head & Neck Medical Oncology, Division of Cancer Medicine, University of Texas M.D. Anderson Cancer Center

Chest wall tumors, which may be cancerous or noncancerous, are tumors of the rib cage and its muscles, connective tissues, and nerves, that can interfere with lung function.

Tumors of the chest wall may develop in the chest wall (called a primary tumor) or spread (metastasize) to the chest wall from a cancer located elsewhere in the body. Almost half of chest wall tumors are noncancerous (benign).

The most common noncancerous chest wall tumors are osteochondroma, chondroma, and fibrous dysplasia.

A wide range of cancerous (malignant) chest wall tumors exist. Over half are cancers that have spread to the chest wall from distant organs or from nearby structures, such as a breast or a lung. The most common cancerous tumors arising from the chest wall are sarcomas.

Chondrosarcomas are the most common primary chest wall sarcoma and arise from cartilage of the anterior tract of ribs and less commonly of the sternum, scapula, or clavicle. Bone tumors include osteosarcoma and small-cell malignant tumors (such as Ewing sarcoma or a skin tumor).

The most common soft-tissue primary cancerous tumors are fibrosarcomas (desmoids and neurofibrosarcomas) and malignant fibrous histiocytomas. Other primary tumors include chondroblastomas, osteoblastomas, melanomas, lymphomas, rhabdomyosarcomas, lymphangiosarcomas, multiple myeloma, and plasmacytomas.

Symptoms

A lump in the chest wall may be the only symptom if a tumor occurs in the soft tissue of the chest wall. Some people have fever. People usually do not have pain until the tumor is advanced. Tumors that form in the bone or cartilage are often painful.

Diagnosis

  • Imaging

  • Biopsy

People with chest wall tumors require imaging tests, such as chest x-ray, computed tomography (CT), magnetic resonance imaging (MRI), and sometimes positron emission tomography (PET)–CT to determine the original site and extent of the tumor and whether it has developed in the chest wall tumor or is a metastasis from a tumor elsewhere in the body. A biopsy may be done to confirm the diagnosis.

Prognosis

Prognosis varies by cancer type, cell differentiation, and stage. However, because these tumors are rare, there is not much information on the usual course of the disease. Survival is better with early-stage disease.

Treatment

  • Surgery

  • Sometimes combination chemotherapy, radiation therapy, and surgery

Most chest wall tumors are removed surgically. If needed, the chest wall is then reconstructed, sometimes with tissues from elsewhere in the body.

In other cases, chemotherapy and radiation therapy, either alone or in combination, are used for treatment.

More Information

* This is the Consumer Version. *