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1、RECONSTRUCTIONOFTHECHESTWALLAFTEREXCISIONOFAGIANTMALIGNANTPERIPHERALNERVESHEATHTUMOURPresentationforreviewduringthezariathoracicclubmeetingOn17thmarch2011AHMADUBELLOUNIVERSITYTEACHINGHOSPITAL,ZARIA,NIGERIAS.A.EDAIGBINI(FWACS)*,I.Z.DELIA(FWACS)*M.B.AMINU(FWACS)*.A.IBRAHIM(FWACS)**,M.O.ASAMA
2、ILA(FMCPath)***,K.ABDULLAHI(MBBS)***,A.A.LIMAN(MBBS)****CardiothoracicSurgeryUnit,DepartmentofSurgery,AhmaduBelloUniversity,Zaria.**Divisionofplasticsurgery,DeptofSurgery,AhmaduBelloUniversity,Zaria.***DepartmentofPathology,AhmaduBelloUniversityZaria.AUTHORSPrimarychestwalltumoursareuncomm
3、onandconstitute0.2-2%ofalltumours.Metastatictumoursandtumoursoflocalextensionaremorecommon.MalignantPeripheralNerveSheathTumourofthechestwallisevenrareranditsincidenceonthechestwallnotstatedintheliteraturesbuttheincidenceinthegeneralpopulationis0.0001%whiletheriskisapproximately4600timeshi
4、gherinpatientswithneurofibromatosis1and3–13%ofthemwillfinallydevelopintoMalignantPeripheralNerveSheathTumour,usuallyafterlatentperiodsof10–20years.Clinically,thesetumoursareaggressive,locallyinvasive,andhighlymetastatic.Excisionofgiantchestwalltumourleavesadefectthatismadegoodbyreconstruct
5、ionusingeithermusculocutaneousflapswithorwithoutamesh.Wereportthecaseofa24yearoldboywhopresentedatthesurgicaloutpatientclinicwithsevenmonthshistoryofpersistentleftsidedchestpainminimallyrelievedbyanalgesics,fivemonthsofcoughandworseningdyspnoeaandthreemonthshistoryofanteriorchestswellingin
6、theregionoftheleftsideofthemanubrium.Followingevaluationandinvestigations,thetumourwasexcisedandtheresidualdefectclosedwithmethylmetacrylatesandwichedbetweentwoprolenemeshesandoverlaidwithbothPectolralisMajormuscles.ThehistologyoftheexcisedmasswasreportedasMalignantPeripheralNerveSheathTum
7、our.Hemadeanuneventfulpostoperativerecoverybutdiedbarely3monthslaterfromwidespreadpulmonarymetastases.Areviewoftheliteraturerevealsthatsuchtumourshardlyeverreachsuchlargesizeasinourcase.ABSTRACTMalignantPeripheralNerveSheathTumour,chestwall,ExcisionReconstruct
