2017 Volume 31 Issue 6 Pages 747-752
A 56-year-old woman presented with left chest pain and chest wall swelling. A tumor of 6 cm in diameter involving the left 8th rib was detected by computed tomography. Left chest wall resection including the 7th, 8th, and 9th ribs coupled with reconstruction with polypropylene mesh was performed, and local control was achieved. Immunohistochemical examinations of the tumor revealed positive reactions to alpha-smooth muscle actin and desmin. Chest wall leiomyosarcoma was finally diagnosed. Initial metastatectomy was performed for solitary liver metastasis 1 year and 11 months later. A total of three liver metastatectomies, a total of three lung metastatectomies, and proton-beam radiotherapy for sacral metastasis were performed over a period of 13 years. The patient was alive without any recurrence at 14 years and 3 months after the first operation. Chest wall leiomyosarcoma is very rare, and no case of a long-term survivor who underwent repeated metastatectomies had been reported prior to the present case in Japan.
