Center for Chest Wall Disease

Overview

The chest wall includes the spine, ribs and muscles that are used for breathing and moving your arms and neck. The chest wall helps protect your organs and creates a strong area that lets breathing happen.

Diseases of the chest wall include non-cancerous (benign) and cancerous (malignant) tumors, developmental abnormalities, and disease caused by an infection or trauma (including prior surgery).

If you have a disease that affects your chest wall, it is important for your doctor to carefully check your breathing. Your doctor should have extensive experience in treating patients with chest wall disease. There are often many things to consider, and expertise is needed to create the best plan of care based on each patient’s needs.

The mission of the Center for Chest Wall Disease is to provide a knowledgeable and experienced multidisciplinary team of experts including surgeons, oncologists, radiation oncologists, medical imaging specialists and medical lung specialists. You will receive:

• A thorough evaluation using state-of-the art diagnostic testing
• Ongoing comprehensive care
• High quality and innovative therapies based on ongoing research and education

What We Treat

Congenital Deformities (present at birth)

• Pectus excavatum
• Pectus carinatum
• Poland Syndrome
• Diaphragm eventration

Acquired Diseases (not present at birth, occur later)

• Acquired thoracic dystrophy
• Flail chest
• Chest wall infections
  • Sternoclavicular joint osteomyelitis
  • Sternal wound infection
• Sternal nonunion
• Chest wall hernia
• Diaphragm hernia

Tumors of the Chest Wall

• Benign
  • Chondroma
  • Osteochondroma
  • Fibrous dysplasia
  • Arteriovenous malformation
  • Eosinophilic granuloma
• Malignant
  • Chondrosarcoma
  • Ewings sarcoma
  • Osteosarcoma
  • Other soft tissue sarcomas
  • Plasmacytoma
  • Desmoid tumor
  • Malignant fibrous histiocytoma
  • Mediastinal Tumor
  • Metastatic cancer in the chest wall
  • Tumors that directly extend into the chest wall
    • Lung cancer
    • Breast cancer

Our Team

Director: Daniel Raymond, MD

Multidisciplinary Team

Thoracic Surgery

• Usman Ahmad, MD
• Sudish Murthy, MD, PhD
• Siva Raja, MD, PhD
• Monisha Sudarshan, MD
• Dean Schraufnagel, MD

Cardiovascular Surgery

• Eric Roselli, MD

Pediatric Surgery

• John DiFiore, MD

Orthopedic Surgery

• Nathan Mesko, MD

Plastic Surgery

• Raymond Isakov, MD

Medical Oncology

• Dale Shepard, MD, PhD

Radiation Oncology

• Jacob Scott, MD

Medical Imaging

• Hakan Ilaslan, MD

Neurosurgery, Center for Spine Health

• Richard Schlenk, MD
• Ajit Krishnaney, MD

Pain Management

• Jianguo Cheng, MD

Make an Appointment

The Center for Chest Wall Disease is located at Desk J4-1, on the 4th floor of the Miller Family Heart, Vascular & Thoracic Institute.

To make an appointment, please call 216.445.6860 or toll-free 800.223.2273, ext. 56860, or submit an online request.

If you would like to talk to our thoracic surgeons before a visit to Cleveland Clinic, select patients now can schedule a previsit online from their home or office by using the Cleveland Clinic Express Care® Online tool. Our resource nurses or individual physician offices can tell you if the surgeon provides this option. If they provide virtual visits, and you are eligible, our team will schedule your virtual visit and provide details on the cost of your appointment and setup instructions.

Referrals, Patient Transfers and Critical Care Transport (for physicians)

We provide several options for physicians and healthcare professionals who wish to refer a patient and/or arrange for emergency transportation.

• Review options

Before your appointment:

If your appointment is at least one week away, please send in your records, including medical history, test results and films (such as echocardiogram, chest X-ray, MRI, CT, etc). All information should be sent to the physician you will be seeing. Put all information in the same package (clearly marked with your name and address) and send it via Airborne Express, Federal Express or certified U.S. mail (make sure you have a tracking number). Films should be sent on disc; radiology reports of those films alone are inadequate and not sending the films could delay your care. The address is:

Daniel Raymond, MD
Center for Chest Wall Disease
Cleveland Clinic Department of Thoracic Surgery
9500 Euclid Avenue – Desk J4-1
Cleveland, OH 44195

If your appointment is less than a week away, please bring your records to your appointment.

Note: Do not send records if you have not made an appointment or registered with the Center for Chest Wall Disease.

What to expect during your appointment:

Our hope is to review your medical records before your appointment so you can see the appropriate team members all on the same day. You will also have all needed tests before you see our team.

On the day of your appointment, you will first meet with a nurse who will get information needed for your visit. Then, you will meet with members of the chest wall team. They will go over your medical history, perform an exam and determine whether you need more testing to help create your plan of care.

We will contact any other specialists you need to see during your first visit.

Please plan on spending at least 2 days in the Cleveland area. This will allow enough time for you to have your initial consult and any other tests or appointments you need. If a procedure is performed at the time of your visit, your condition and treatment will guide the length of stay.

Follow-up

Your follow-up care is an important part of your overall plan of care. Your follow-up schedule will be based on your condition and type of treatment that is best for you. Your doctor will talk to you about follow-up visits. Please let us know about any questions or concerns you have.

Traveling to Cleveland Clinic

To help make your visit to Cleveland Clinic as easy as possible, please visit:

• Information on travel to the Miller Family Heart, Vascular & Thoracic Institute.

More Information

If you need more information, click here to contact us or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

News

Patient Stories

• Patient with “Sunken Chest” Celebrates Life After Surgery

Publications

• Coombs, Demetrius M. MDa; Aliotta, Rachel MDa; Jagadeesh, Deepa MDb; Raymond, Daniel MDc; Isakov, Raymond MDa Breast Implant-Associated Anaplastic Large Cell Lymphoma With Invasive Chest Wall Masses, Annals of Plastic Surgery: June 23, 2021 - Volume Publish Ahead of Print - Issue - doi: 10.1097/SAP.0000000000002910 https://journals.lww.com/annalsplasticsurgery/Abstract/9000/Breast_Implant_Associated_Anaplastic_Large_Cell.96162.aspx
• Zaki AL, Vargo PR, Schraufnagel DP, Kalahasti V, Murthy S, Roselli EE, Raymond DP. Modified Ravitch Procedure for Pectus Excavatum Combined With Complex Cardiac Surgery. Semin Thorac Cardiovasc Surg. 2021 Mar 6:S1043-0679(21)00108-8. doi: 10.1053/j.semtcvs.2021.02.028. Epub ahead of print. PMID: 33689924.  https://pubmed.ncbi.nlm.nih.gov/33689924/
• Mesko NW, Bribriesco AC, Raymond DP. Surgical Management of Chest Wall Sarcoma. Surg Oncol Clin N Am. 2020 Oct;29(4):655-672. doi: 10.1016/j.soc.2020.06.008. Epub 2020 Aug 12. PMID: 32883465. https://pubmed.ncbi.nlm.nih.gov/32883465/
• Hale J, Cheng J. Spinal cord stimulation for neurogenic thoracic outlet syndrome: A case report. A&A Practice, 2020;14(6):e01194.  
• Suchy T, Diep J, Cheng J. (2020) Chapter 22. Epidural Steroid Injections. In (Jianren Mao ed.) p281-290. Spine Pain Care: A Comprehensive Clinical Guide. Springer-Nature, 2020, Cham, Switzerland. 
• Lowery DR, Raymond DP, Wyler DJ, Marciniak DA. Continuous Erector Spinae Plane Blocks for Adult Pectus Excavatum Repair. Ann Thorac Surg. 2019 Jul;108(1):e19-e20. doi: 10.1016/j.athoracsur.2018.11.061. Epub 2018 Dec 28. PMID: 30597141. https://pubmed.ncbi.nlm.nih.gov/30597141/
• Cheng J. (2019). Chapter 11. Herpes Zoster and Postherpetic Neuralgia. In (Jianguo Cheng Ed.) Neuropathic pain: A Case Based Approach to Practical Management. P93-98, Oxford University Press, 2019. New York, NY, USA.  
• Cheng J, Rosenquist RW. (2018). Chapter 24. Herpes Zoster and Postherpetic neuralgia. In (Jianguo Cheng, Richard W. Rosenquist eds). Fundamentals of Pain Medicine. Springer-Nature, 2018, Cham, Switzerland.  
• Cho YJ, Cheng J. (2017). Patient with thoracic spine pain. Nature: Scientific American, Pain Management. In (Alan Kaye Ed.)  
• Cheng J (2017). Chapter 13. Thoracic epidural and nerve root injections (Fluoroscopy). In (S Narouze ed) Multimodality Imaging Guidance in Interventional Pain Management. P171-182. Oxford University Press. 
• Cheng J. (2017). Patient with post-thoracotomy pain. Nature: Scientific American, Pain Management. (Alan Kaye Ed.)  
• Maheshwari A, Cheng J. (2014). Chapter 16. Patient with thoracic spine pain. Case Studies in Pain Management. (Alan Kaye and Rinoo Shah, eds). P123-130. Cambridge University Press.  
• Mekhail N, Cheng, J.  Temperature mapping of cooled radiofrequency lesion of human cadaver thoracic facet medial branches. Clinical Journal of Pain, 2011; 27(1): 56–61. https://journals.lww.com/clinicalpain/Abstract/2011/01000/Temperature_Mapping_of_Cooled_Radiofrequency.8.aspx
• Pope J, Cheng J. (2010) Facet joint injections: cervical, lumbar, and thoracic. Pages 129-135.  In (H Benzon, M Huntoon, and S Narouze eds): Spinal Injections and Peripheral Nerve Blocks, 1st Edition. Elsevier. 
• Smith H, Burton A, Cheng J, Nguyen R, Chopra P.  (2009) Chapter 23. Intercostal Nerve Blocks. Pages 281-290. In (L Manchikanti and V Singh eds): Interventional Techniques in Chronic Non-spinal Pain. ASIPP Publishing, USA.  
• Cheng J, Cata J.(2008) Interpleural Analgesia. Chapter 13, pages 92-94.  In (H Smith, ed): Current Therapy in Pain. Elsevier (Saunders).