Giant Chest Wall Tumor Resection and Reconstruction With Video-Assisted Thoracic Surgery

A healthy 26-year-old male was referred to thoracic surgery for a large mass in his upper back. Imaging revealed a 24 cm x 16 cm x 7 cm lipomatous mass that was invading the chest cavity. MRI suggested that the mass was an atypical lipoma. The authors decided to attempt a video-assisted chest wall resection and reconstruction instead of a thoracotomy, in order to improve visualization of the intrathoracic resection and reconstruction, allow for a smaller incision, spare the uninvolved musculature, and provide for a faster recovery and a shorter hospital stay while minimizing pain. There were no complications and the patient was discharged home on postoperative day four. Histologic examination revealed mature adipose tissue without atypia, consistent with a diagnosis of intramuscular lipoma. Follow-up was uneventful; the patient achieved full recovery through physical therapy. The use of a hybrid video-assisted approach for this giant chest wall tumor optimized outcomes for this patient.

This video is also authored by Robert J. Canter.