Chest Wall Tumors

Abstract

The incision used to resect a tumor in the chest wall is determined by the shape of the tumor and the orientation of its longitudinal axis. If the tumor is elongated in any direction, the incision is made along the longitudinal axis of the ellipse outlined by the tumor protuberance. Most tumors tend to be somewhat spherical in shape, however, and then the preferred incision is an oblique one over the middle of the mass, extending well proximal and distal to the mass along the direction of the ribs. An ellipse is made to circumscribe the site of a prior biopsy of the mass, which then can be removed en bloc with the underlying tumor (Fig. 19.1). Flaps are developed well beyond the palpable extent of the tumor. The investing fascia is incised above and below the area of the tumor (Fig. 19.2). Depending on whether the tumor is located on the posterior or anterior chest wall, the latissimus dorsi and/or the serratus anterior becomes exposed.