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En-Bloc Chest Wall Resection
Sonia L. Betancourt Cuellar, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Resection of invasive malignancy and adjacent structures
              • Lung, parietal pleura, and visceral pleura
              • Portion of chest wall
                • Endothoracic fascia, intercostal muscles, and ribs
                • ± superficial tissues (muscle and fat)
                • ± portion of vertebral bodies, sternum
            • Chest wall reconstruction may be necessary following en-bloc resection
              • Defects close to scapular tip, > 5 cm; > 2 ribs resected, involvement of lower ribs
              • No reconstruction: Defect < 5 cm, first 2-3 ribs resected

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Natural History & Prognosis

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              Selected References

                              1. Alpert JB et al: Imaging the post-thoracotomy patient: anatomic changes and postoperative complications. Radiol Clin North Am. 52(1):85-103, 2014
                              2. Santos HT et al: Lung cancer with chest wall invasion: retrospective analysis comparing en-bloc resection and 'resection in bird cage'. J Cardiothorac Surg. 9:57, 2014
                              3. Aghajanzadeh M et al: Results of chest wall resection and reconstruction in 162 patients with benign and malignant chest wall disease. J Thorac Dis. 2(2):81-5, 2010
                              4. Ferraro P et al: Principles of chest wall resection and reconstruction. Thorac Surg Clin. 20(4):465-73, 2010
                              5. Riquet M et al: Non-small cell lung cancer invading the chest wall. Thorac Surg Clin. 20(4):519-27, 2010
                              6. En bloc resection for lung cancer with chest wall invasion. J Chin Med Assoc. 69(4):157-61, 2006
                              7. Voltolini L et al: Lung cancer with chest wall involvement: predictive factors of long-term urvival after surgical resection. Lung Cancer. 52(3):359-64, 2006
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Pathology

                                    • Clinical Issues

                                      TERMINOLOGY

                                      • Definitions

                                        • Resection of invasive malignancy and adjacent structures
                                          • Lung, parietal pleura, and visceral pleura
                                          • Portion of chest wall
                                            • Endothoracic fascia, intercostal muscles, and ribs
                                            • ± superficial tissues (muscle and fat)
                                            • ± portion of vertebral bodies, sternum
                                        • Chest wall reconstruction may be necessary following en-bloc resection
                                          • Defects close to scapular tip, > 5 cm; > 2 ribs resected, involvement of lower ribs
                                          • No reconstruction: Defect < 5 cm, first 2-3 ribs resected

                                      IMAGING

                                      • General Features

                                        • Radiographic Findings

                                          • CT Findings

                                            • Ultrasonographic Findings

                                              • Imaging Recommendations

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    CLINICAL ISSUES

                                                    • Presentation

                                                      • Natural History & Prognosis

                                                        DIAGNOSTIC CHECKLIST

                                                        • Consider

                                                          Selected References

                                                          1. Alpert JB et al: Imaging the post-thoracotomy patient: anatomic changes and postoperative complications. Radiol Clin North Am. 52(1):85-103, 2014
                                                          2. Santos HT et al: Lung cancer with chest wall invasion: retrospective analysis comparing en-bloc resection and 'resection in bird cage'. J Cardiothorac Surg. 9:57, 2014
                                                          3. Aghajanzadeh M et al: Results of chest wall resection and reconstruction in 162 patients with benign and malignant chest wall disease. J Thorac Dis. 2(2):81-5, 2010
                                                          4. Ferraro P et al: Principles of chest wall resection and reconstruction. Thorac Surg Clin. 20(4):465-73, 2010
                                                          5. Riquet M et al: Non-small cell lung cancer invading the chest wall. Thorac Surg Clin. 20(4):519-27, 2010
                                                          6. En bloc resection for lung cancer with chest wall invasion. J Chin Med Assoc. 69(4):157-61, 2006
                                                          7. Voltolini L et al: Lung cancer with chest wall involvement: predictive factors of long-term urvival after surgical resection. Lung Cancer. 52(3):359-64, 2006