Abstract
We report a case of a 57-year-old male who presented with an inoperable chest wall sarcoma due to numerous pulmonary metastases and was treated with chemotherapy and radiation therapy. The patient subsequently developed refractory bleeding from the chest wall tumor requiring palliative chest wall resection and reconstruction. The patient made an uneventful recovery however died from metastatic disease 8 months later. This case represents a very rare indication for palliative chest wall resection.
Highlights
Soft tissue sarcomas represent less than 1% of malignancies occurring in the adult population and those arising from the chest wall comprise between 10% and 20% of these cases [1,2]
Local complications as a result of radiation therapy can occasionally occur such as skin ulceration, pain syndromes, and extensive tumor necrosis for which palliative surgery can improve the remaining quality of life [4]
We report a case of refractory bleeding from tumor necrosis after chemotherapy and radiation therapy that required operative intervention for palliation
Summary
Soft tissue sarcomas represent less than 1% of malignancies occurring in the adult population and those arising from the chest wall comprise between 10% and 20% of these cases [1,2]. Management of chest wall sarcomas typically involves a multimodality approach including wide surgical resection with reconstruction [3]. Local complications as a result of radiation therapy can occasionally occur such as skin ulceration, pain syndromes, and extensive tumor necrosis for which palliative surgery can improve the remaining quality of life [4]. At the time of presentation, there were numerous pulmonary metastases and he was not felt to be a surgical candidate. He received 3 cycles of doxorubicin and ifosfamide chemotherapy resulting in a modest radiographic response in the. At the time of surgery, wide chest wall excision was performed with an approximately 3 cm circumferential gross tumor free margin. He did well for 6 months developed metastatic disease to the bone and brain and died 8 months following surgery
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