Why does a "bag" grow on the chest wall?
is so scary, is it important?
Please see a doctor!
How are most chest wall tumors discovered?
Many patients accidentally touched the chest wall and found that it was a "breast wall tumor".
Therefore, most patients with early chest wall tumors have no obvious symptoms. The discovery and severity of the symptoms are closely related to the size, growth rate and the pathological type of the tumor.
Benign chest wall soft tissue mass can generally be pushed, while thoracic wall bone tumors are relatively fixed and difficult to push.
Tumors of the anterior chest wall or lateral chest wall are generally more likely to be discovered, while tumors of the posterior chest wall are often easily overlooked due to thicker soft tissue or covered by the scapula.
What is chest wall tumor?
Chest wall tumor refers to tumors whose growth location is located in the deep tissue of the chest wall. It covers the chest wall muscles, ribs, sternum, nerves, and blood vessels, but does not include tumors located on the surface of the chest wall skin, the subcutaneous fat layer of the chest wall and the breast, nor does it include tumors located in the clavicle or scapula.
Chest wall tumors can be divided into chest wall soft tissue tumors and chest wall bone tumors according to the site of occurrence. Like tumors in other body parts, chest wall tumors are also divided into benign and malignant. Chest wall tumors account for 5% of chest tumors, about 30%-50% are malignant. bone tumor , which is primary in the chest wall, accounts for about 5%-10% of the primary bone tumors in the body, of which 80% occur in the ribs and 20% occur in the sternum, mainly malignant. Rib tumors tend to occur in the anterior and lateral chest walls, and rarely in the posterior chest wall.
What are the factors of chest wall tumors?
is still not very accurate at present. Like tumors in other parts of the body, it may be related to many factors. Common ones include:
Congenital factors: family tumor inheritance, autogene mutation, etc.;
Acquired factors: bad lifestyle (smoking, alcoholism, obesity, lack of exercise, etc.), or long-term exposure to radiation stimulation and stimulation Learn harmful substances, or chronic inflammation of the chest wall, and repeatedly stimulate after a long time;
Tumors in other parts metastasize to the chest wall;
Inducible factors: insufficient sleep and rest, long-term high-load work, high-intensity mental stimulation; hormone levels in the body are disordered or; chronic infections in the body, etc. How to find chest wall tumors through clues?
Local mass : Chest wall lump is a common symptom of chest wall tumors. Benign tumors often show slow growth and gradually enlarged chest wall masses, while malignant tumors grow faster. The size, depth, location and texture of the mass appear differently according to the benign and malignant nature of the tumor. The benign tumor with shallow location can be pushed when palpated, and the malignant tumor is fixed and tender.
Chest wall pain : Pain is one of the early symptoms of chest wall bone or cartilage tumors. The reason why many patients with chest wall tumors are chest wall pain, which may be accompanied by or without local lumps. Pain in chest wall tumors is usually caused by the tumor affecting surrounding tissues, especially the nerves. Although both benign and malignant chest wall tumors can cause pain, most chest wall pain often suggests that the tumor may be malignant.
Sensory abnormalities: This situation often occurs when the chest wall tumor compresses or invades surrounding tissues (mainly neural tissue ). For example, compressing or invading brachial plexus nerve or intercostal nerve will cause pain and discomfort in the nerve distribution area; when compressing or invading sympathetic nerve , it will cause numbness, pain and other sensory abnormalities in limb ptosis, pupil shrinkage, and local facial non-sweat.
Respiratory Symptoms : Some chest wall tumors may also affect the patient's respiratory status.This is more common when chest wall tumors are too huge and compress the lung tissue, or chest wall tumors cause pleural effusion , lung incomplete , lung infection , etc., resulting in a reduction in the effective area of lung ventilation or lung ventilation, resulting in the patient's chest tightness shortness of breath, difficulty breathing, etc.
What examinations do you need to do for chest wall tumors?
Physical examination :
If the body surface can palpate the tumor, the doctor will make a preliminary judgment on the nature of the tumor through palpation.
Through the doctor's hand palpation, you can understand the size, location, texture, tumor mobility, the relationship between the tumor and surface skin tissue, and even changes in the surface skin color and temperature of the tumor to predict the tumor.
Imaging examination:
X-ray: can show bone erosion, osteolysis, mediastinal swollen lymph nodes and larger diameter intrapulmonary lesions, but with the widespread use of CT, X-rays are currently rarely used in clinical practice.
Chest CT (including three-dimensional CT of the ribs): is used to evaluate the degree of involvement of bone, soft tissue, pleura and mediastinal organs, whether there is lung metastasis, etc. It can also help diagnose the etiology of chest wall tumors and initial differential diagnosis. Currently, chest CT is the best imaging method to identify the location and characteristics of most chest wall tumors.
MRI: is mainly used to further evaluate the degree of involvement of muscle soft tissues around the lesion, the relationship between the lesion and nearby blood vessels, and the degree of invasion of the lesion on the nerves, spine, and spinal cord. However, CT is still better than MRI for the assessment of calcification and lung involvement.
isotope systemic bone scan: is mainly used to determine the metabolism of the bone in the lesion, help judge benign and malignant, and whether there are lesions in other parts of the body.
PET-CT: is more sensitive to the judgment of whether there is metastasis of sarcoma and lymph node . It can also be used as a means to detect systemic tumor status, and its staging of chest wall tumors is better than traditional CT and MRI.
Pathological tissue examination:
The diagnosis of chest wall tumors depends on pathological tissue examination, which we call biopsy . The treatment methods for chest tumors of different natures vary greatly. The purpose of biopsy is to clarify the nature of the tumor and can scientifically formulate treatment plans.
There are three commonly used biopsy methods: puncture biopsy , incision biopsy, and resection biopsy.
puncture biopsy :
Use puncture needle to obtain a small amount of tumor tissue. Its main advantage is that soft tissue damage is small, easy to operate, relatively safe, and has a low incidence of complications. It is the preferred method of tissue material selection. However, there is a problem that the tumor tissue cannot be accurately obtained and the tumor tissue is not accurately determined.
For some bone tumors, it may not be punctured due to their hard texture.
In addition, for malignant tumors, although the incidence is extremely low, there is a possibility of puncture leading to tumor transplantation.
Incisional biopsy :
When the chest wall tumor is not easy to puncture, or the puncture biopsy cannot be confirmed, and patients with larger tumors can consider incisional biopsy, which often require local anesthesia or general anesthesia .
Resection biopsy :
. When the tumor diameter is small and can be evaluated to be safe and complete resection, direct surgical resection of the tumor biopsy can be considered. Its advantages include complete resection of the lesions, sufficient pathological specimens, and early adjuvant treatment for certain lesions.
Expert introduction:
Wu Weiming
Deputy Chief Physician of the Department of Thoracic Surgery, Sixth People's Hospital Affiliated to Shanghai Jiaotong University. Member of the Thoracic Surgery Professional Committee of the Shanghai Society of Integrated Traditional Chinese and Western Medicine, a member of the Chest Trauma Group of the Thoracic Surgery Branch of the China Association for International Exchange of Healthcare, a Shanghai Resident Standardized Training Combined with Comprehensive Assessment Examiner, and a medical expert of the Shanghai Labor Capacity Status Technical Assessment Group.He participated in many major projects of the municipal bureau, published dozens of Chinese journals as the first author, and published more than 410 SCI papers.
has been engaged in thoracic surgery for more than 20 years, and is proficient in the diagnosis and surgical treatment of common thoracic surgery diseases. He has rich experience in the diagnosis and treatment of chest wall tumors and chest wall reconstruction surgery after tumor resection, and has a lot of experience in the diagnosis and treatment of severe and complex chest trauma.
General clinic time:
Monday afternoon
Friday afternoon
Friday afternoon
Expert clinic time:
Thursday morning
Author: Deputy Chief Physician of the Department of Thoracic Surgery, Sixth People's Hospital Affiliated to Shanghai Jiaotong University Wu Weiming
correspondent: Gu Haiying
Editor: Huang Mengmei
Review: Chen Shirui
Release: Xie Tao
Issued: Xie Tao
Picture: Some pictures in this article are from the Internet and the copyright belongs to the original author. If there is any infringement, please contact us to delete it.
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