Chest wall resection in locally advanced or recurrent breast cancer - series of three cases.

BACKGROUND: The usefulness of chest wall resection in breast cancer is poorly defined as extensive surgical resection is seen inappropriate, as it is regarded as harbinger of systemic disease. We report our experience of chest wall resection in recurrent or locally advanced breast cancers Case Presentation: We reviewed our institute records for chest wall resection in locally advanced or locally recurrent breast cancers from 2016 - 2018. There were 3 cases of chest wall resection for carcinoma breast. 1 for recurrent breast cancer and 2 for locally advanced breast cancer after neoadjuvant chemotherapy. Preoperative symptoms were ulceration in recurrent tumor, pain and mass in other. One patient needed Lattismus dorsi (LD) myocutaneous flap and one required a free flap. One underwent LD muscle flap. Mean postop stay were 8 days. One patient required redo flap surgery for partial flap necrosis Conclusions: Full thickness chest wall resection is relatively safe procedure with acceptable morbidity and can be considered in carefully selected patients Key Words: Breast carcinoma-Chest wall recurrence- Chest wall resection-chest wall reconstruction.

Thoracoscopic (hybrid) complex chest wall resection in pediatric Ewing sarcoma.

Askin tumor (a Ewing sarcoma variant) is the most common tumor of the chest wall in the pediatric age group. Multimodal treatment is required, with complete resection being the cornerstone of effective management. We describe the case of a 13-year boy with a left paraspinal Ewing sarcoma with intraspinal extension and spinal cord compression with neurological weakness. He underwent complex surgical resection using thoracoscopic resection of multiple ribs along with vertebral resection and reconstruction, after neoadjuvant therapy.

Solitary recurrence at intercostal drain site in oesophageal adenocarcinoma.

56 year old gentleman was evaluated for dysphagia and diagnosed with oesophageal adenocarcinoma and had undergone Transhiatal Oesophagectomy elsewhere, pT3N0, but had defaulted adjuvant treatment. He presented 15 months later to us with nodule at left intercostal drain (ICD) drain site. Positron Emission Tomography (PET) scan showed it to be single site metastasis and he underwent wide excision, followed by six cycles of chemotherapy. He is symptom free and on regular follow up for a period of ten months. Oesophageal cancer although with poor prognosis can be considered for metastatectomy after considering the disease free interval, site of recurrence and histological factors in carefully selected patient.