OF THE CHESTWALL AFTER 后的胸壁重建ppt课件.pptxVIP

RECONSTRUCTION OF THE CHESTWALL AFTER EXCISION OF A GIANT MALIGNANT PERIPHERAL NERVE SHEATH TUMOUR; S.A. EDAIGBINI (FWACS)*, I.Z.DELIA (FWACS)*M.B.AMINU (FWACS)*. A. IBRAHIM (FWACS) **, M.O.A SAMAILA (FMCPath) ***,K.ABDULLAHI(MBBS)***, A.A.LIMAN (MBBS) *** *Cardiothoracic Surgery Unit, Department of Surgery, Ahmadu Bello University, Zaria. **Division of plastic surgery, Dept of Surgery, Ahmadu Bello University, Zaria. ***Department of Pathology, Ahmadu Bello University Zaria.??; Primary chest wall tumours are uncommon and constitute 0.2-2% of all tumours. Metastatic tumours and tumours of local extension are more common. Malignant Peripheral Nerve Sheath Tumour of the chestwall is even rarer and its incidence on the chestwall not stated in the literatures but the incidence in the general population is 0.0001% while the risk is approximately 4600 times higher in patients with neurofibromatosis 1 and 3–13% of them will finally develop into Malignant Peripheral Nerve Sheath Tumour, usually after latent periods of 10–20 years. Clinically, these tumours are aggressive, locally invasive, and highly metastatic. Excision of giant chestwall tumour leaves a defect that is made good by reconstruction using either musculocutaneous flaps with or without a mesh. We report the case of a 24 year old boy who presented at the surgical outpatient clinic with seven months history of persistent left sided chest pain minimally relieved by analgesics, five months of cough and worsening dyspnoea and three months history of anterior chest swelling in the region of the left side of the manubrium. Following evaluation and investigations, the tumour was excised and the residual defect closed with methylmetacrylate sandwiched between two prolene meshes and overlaid with both Pectolralis Major muscles. The histology of the excised mass was reported as Malignant Peripheral Nerve Sheath Tumour. He made an uneventful postoperative recovery but died barely 3 months later from w