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Journal of Thoracic Oncology:
doi: 10.1097/JTO.0b013e3181ad803f
Letter to the Editor

Surgical Management of an Inoperable Giant Pleomorphic Rhabdomyosarcoma of the Chest Wall

Köse, Rüstü MD; Kürkçüoğlu, Ibrahim Can MD; Demir, Deniz MD

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Department of Plastic and Reconstructive Surgery; Harran University Medical School; Sanliurfa, Turkey (Köse)

Department of Thoracic Surgery; Harran University Medical School; Sanliurfa, Turkey (Kürkçüoğlu)

Department of Cardiovascular Surgery; Harran University Medical School; Sanliurfa, Turkey (Demir)

Disclosure: The authors declare no conflicts of interest.

Address for correspondence: Rüstü Köse, MD, Department of Plastic and Reconstructive Surgery, Harran University Medical School, Sanliurfa, Turkey. E-mail: rkose@harran.edu.tr

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To the Editor:

A 65-year-old men was referred to our hospital with a complaint of giant mass on the chest wall, which reached its present size to 3 cm in 5 months. On physical examination, the mass was firm, fixed, necrotized, and nontender (Figure 1). Metastatic lesions were detected in the lung. An incisional biopsy of the tumor confirmed the diagnosis of pleomorphic rhabdomyosarcoma, 2 months ago in another clinic. The patient was considered as inoperable because the lung was metastatic, and the mass excision was not performed. Serous leakage, observed in the incision area, was irritating for the patient. The patient brought to our clinic for the mass excision. The mass was totally excised. The size of the tumor was 16 × 16 × 15 cm, and the weight was 1750 g. The chest wall and the axillary skin defect were reconstructed with a latissimus dorsi muscle flap. The skin was primarily closed. After the operation, the patient has received chemotherapy in an oncological center. The postoperative course was uneventful, and no recurrence was found. The patient is still alive after 6 months follow-up and was satisfied from the operation. Surgical excision has not seemed to contribute to the improvement in survival after the mainstay of local disease control on chest wall rhabdomyosarcoma.1 The excision of giant tumors is usually not preferred because of its hardness, and it is useless for survival. Still, resection of giant mass can improve the patient’s condition and may provide a good quality of life.2

Figure 1
Figure 1
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Rüstü Köse, MD

Department of Plastic and Reconstructive Surgery

Harran University Medical School

Sanliurfa, Turkey

Ibrahim Can Kürkçüoğlu, MD

Department of Thoracic Surgery

Harran University Medical School

Sanliurfa, Turkey

Deniz Demir, MD

Department of Cardiovascular Surgery

Harran University Medical School

Sanliurfa, Turkey

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REFERENCES

1. Hayes-Jordan A, Stoner JA, Anderson JR, et al. The impact of surgical excision in chest wall rhabdomyosarcoma: a report from the Children’s Oncology Group. J Pediatr Surg 2008;43:831–836.

2. Karaoğlanoğlu N, Kürkçüoğlu IC, Eroğlu A. Giant neurofibroma of the chest wall. Ann Thorac Surg 2004;78:718.

© 2009International Association for the Study of Lung Cancer

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