[Special diagnostic and therapeutic problems with primary bone tumors of the chest wall].

The rare primary bone tumors of the chest wall have to be distinguished from metastatic or specific inflammatory bone diseases as well as from neoplasm of mediastinal or bronchogenic origin secondarily involving the chest wall. Their x-ray appearance may lead to confusion with pulmonary or mediastinal tumors. Since definite diagnosis by x-ray studies including computed tomography is not possible and many of these tumors are malignant or tend to recur locally, radical resection is mandatory. From 1970 to 1982 34 primary tumors of the bony chest wall were observed. A definite histological diagnosis was obtained in 28 cases. Ten tumors were malignant, chondrosarcoma being the most frequent ones. Tumor resections were carried out in 27 patients, the surgical procedures being single rib resection (17), multiple rib resection (6), partial sternum resection (2) and thoracotomy (2) for tumor enucleation. In 8 cases chest wall defects had to be covered with lyophilized Dura mater (2), with diaphragm (2), subscapular (1) and pectoral muscle flaps (3).