Giant Thoraco-abdominal Tumor - A Surgical Challenge. Case Report
C. Grozavu, M. Iliaş, D. Marin, D. Pantile, A. CiucheClinical case, no. 2, 2014
Background: During the last three decades, severalimprovements in surgical and anesthetic techniques haveallowed a better management of primary and secondarytumors of the chest wall.Objectives: Chest wall tumors, regardless of their location,anterior, posterior or lateral, have always been a challengefor the thoracic surgeon through technical and tacticalproblems they entail. The most common techniques toreconstruct a full thickness defect are by the use ofalloplastic material and filling the soft tissue defect withmyocutaneous flap.Method: We present the unusual case of a 45 years old patientwith a giant right thoraco-abdominal tumor, developing forthe last 22 years. The tumor occupied the lower half of theright hemithorax and the right hemiabdomen, down to theright iliac crest. The tumor also developed inside the thoraciccavity, with the invasion of the last 3 ribs, of the diaphragm(partial) and with intra-abdominal invasion of a liver sectionand the right kidney.Results: The surgery team had special problems related to:providing training and logistics, in-block tumor resection inoncological limits, followed by complex thoraco-abdominalreconstruction. The results were very good, with a favorablepostoperative evolution, without any complications, thepatient being discharged with the recommendation to comefor follow-up on his condition.Conclusions: A complex surgical intervention proved to bethe only solution for saving the patient, for which the lifedue to the tumor’s size became almost unbearable.
