Extirpation of Tumors Located Near the thoracic Cage: A Method for Increasing the Margin of Healthy Tissue on the Deep Side of the Tumor

Abstract

When an aggressive tumor develops in a flat muscle near the thoracic cage the question may arise as to how achieve an adequate margin on the deep side of the tumor. This is especially the case if the tumor has recurred after a previous non-radical operation. A method is described by which the external thoracic fascia, the external intercostal musculature, and the periosteum on the external surface of the ribs can be included in the specimen as a continuous wall of healthy tissue on the deep side of the tumor. This technique has been used in 11 patients, 9 of whom had undergone one or more inadequate operations earlier. Eight patients had a malignant tumor, three an extra-abdominal desmoid. In one of the latter patients, in whom a recurrent tumor was adherent to rib periosteum, the method was unsuitable. In the other patients the method appears to have been adequate for local control of the tumor.