Chest Wall Tumors and Sarcomas

The chest wall plays an important role in keeping our organs safe. It is the bone-and-tissue framework that forms a cage around vital organs such as the heart and lungs. The chest wall includes the spine, sternum, and ribs. Many types of tumors can grow in this structure. Some are primary tumors, which originate in the chest wall; these can be either benign or malignant. Others are secondary tumors, which spread (metastasize) to the chest wall from another site in the body. When tumors metastasize, they are almost always malignant.

When a tumor forms in the bones, soft tissue, or cartilage, and is malignant, we call it a sarcoma. Malignant chest wall tumors include many types of sarcoma. Symptoms of chest wall sarcomas vary with the tumor’s classification and severity. You might experience difficulty breathing as well as pain and swelling surrounding the tumor.

Types of Chest Wall Sarcomas

The following types of sarcomas could grow in the chest wall:

• Chondrosarcoma: Forms in cartilage and is the most common type of primary chest wall bone cancer. It usually presents as a slowly enlarging, painful mass.
• Osteosarcoma: Forms in bone, typically during a period of accelerated growth, such as adolescence. It typically presents as a rapidly enlarging, painful mass.
• Ewing’s sarcoma: Forms in bone, and most often affects children and young adults. It usually presents as a painful mass with fever and fatigue.
• Plasmacytoma: Arises from plasma cells and is an isolated form of multiple myeloma. You may feel pain but not see a mass. This is one of the few chest wall tumors that we rarely treat surgically.
• Malignant fibrous histiocytoma: The most common soft tissue sarcoma, this often occurs in adults. These usually present as a slowly growing, painless mass.
• Rhabdomyosarcoma: Forms in striated muscle, and most often affects children and young adults. These usually present as a rapidly growing, painless mass.

Diagnosis and Treatment

The process of diagnosing a chest wall tumor typically begins with a physical exam, followed by an imaging test, such as an X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI). If we need additional information, we may do a biopsy. This involves taking a tissue sample from the tumor and testing it in the lab.   

We design a treatment plan based on the type and stage of tumor you have. Surgical resection is the mainstay of treatment for most early stage chest wall tumors. Additional treatment can include radiation and chemotherapy.

Why Mount Sinai

At Mount Sinai, your thoracic surgeon coordinates a team of specialists to manage your disease. Our goal is to remove the entire tumor without affecting your ability to breathe. We also protect your underlying chest structures, including your heart and lungs. We strive to cure your disease while maintaining your quality of life.