Minervini Fabrizio, Sergi Consolato Maria, Scarci Marco, Kestenholz Peter B, Valentini Leonardo, Boschetti Laura, Bertoglio Pietro
Division of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Division of Anatomic Pathology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
J Thorac Dis. 2024 Jan 30;16(1):722-736. doi: 10.21037/jtd-23-464. Epub 2024 Jan 5.
Benign tumors of the chest wall are rare tumors that might arise from all the tissues of the chest: vessels, nerves, bones, cartilage, and soft tissues. Despite benign features, these tumors can have several histological characteristics and different behaviors. Even if they do not influence life expectancy, rarely they may have a potential risk of malignant transformation. They can cause several, oft, unspecific symptoms but more than 20% of affected patients are asymptomatic and are being diagnosed incidentally on chest radiograph or computed tomography scan. Pain is the most common described symptom. Together with a detailed medical history, a rigorous and meticulous clinical and radiological assessment is mandatory. If radiological features are unclear or in case surgery could not be performed, a biopsy should be indicated to establish a diagnosis. Radical surgical resection can often be offered to resect and cure these neoplasms, but this is might not be true for all types of tumors and, in some cases, their dimension or position might contra-indicate surgery. Given the rarity of these tumors, there is a lack of treatment's guidelines and prospective trials that include a significant number of patients. This review discusses, according to the latest evidence, the histological features and the best treatment of several chest wall benign tumors.
胸壁良性肿瘤是一种罕见肿瘤,可能起源于胸部的所有组织:血管、神经、骨骼、软骨和软组织。尽管具有良性特征,但这些肿瘤可具有多种组织学特征和不同行为。即使它们不影响预期寿命,但很少情况下可能有恶性转化的潜在风险。它们可引起多种通常不具特异性的症状,但超过20%的患者无症状,是在胸部X线片或计算机断层扫描时偶然发现的。疼痛是最常描述的症状。结合详细的病史,严格细致的临床和影像学评估必不可少。如果影像学特征不明确或无法进行手术,应进行活检以明确诊断。根治性手术切除通常可用于切除并治愈这些肿瘤,但并非所有类型的肿瘤都是如此,在某些情况下,肿瘤的大小或位置可能不适合手术。鉴于这些肿瘤的罕见性,缺乏包含大量患者的治疗指南和前瞻性试验。本综述根据最新证据,讨论了几种胸壁良性肿瘤的组织学特征和最佳治疗方法。