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Rao J, Zhu Q, Yang X. Giant primary liposarcoma of the mediastinum: A case report and review of the literature. SAGE Open Med Case Rep 2023; 11:2050313X231206031. [PMID: 37860286 PMCID: PMC10583509 DOI: 10.1177/2050313x231206031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023] Open
Abstract
Liposarcoma is a carcinomatous mesenchymal tumor with various histologic features and is the most common soft tissue sarcoma originating in adipose tissue. Liposarcoma commonly occurs in the lower extremities and retroperitoneum but rarely in the mediastinum, specially extending into the thoracic cavity. We report a giant primary liposarcoma of the posterior mediastinum in a 63-year-old female who complained of cough, sputum, and pain in the right chest wall. A computed tomography scan of the chest showed a giant mass of 24 × 15 × 24 cm in the posterior mediastinum of the right thoracic cavity. After a thorough examination, no suspected lipomatous lesions were found elsewhere in the patient's body. The patient underwent a thoracotomy to remove the mediastinal mass through a right thoracic approach. Subsequently, hematoxylin-eosin staining revealed dedifferentiated liposarcoma (DDL), immunohistochemistry showed positive expression of cyclin-dependent kinase 4, and murine double minute 2 (MDM2), in addition, fluorescence in situ hybridization for the MDM2 gene was also positive, which suggested DDL. The patient was discharged without any complications, and no metastasis or recurrence was observed after 19 months of follow-up. To provide a reference for clinical diagnosis and treatment, we reviewed and discussed the literature on primary liposarcoma of the mediastinum.
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Affiliation(s)
- Jingjing Rao
- Department of Laboratory, Shiyan Maternal and Child Health Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
| | - Qingling Zhu
- Department of Internal Medicine, Yicheng Hospital of Traditional Chinese Medicine, Xiangyang, Hubei, P.R. China
| | - Xuejiao Yang
- Department of Laboratory, Shiyan Maternal and Child Health Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
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Wong GS, Bass D, Chen IY, Thomas R, Velez MJ, Hobbs SK. Imaging and Clinical Findings in a Series of Six Cases of Rare Primary Mediastinal Liposarcoma. Radiol Cardiothorac Imaging 2022; 4:e210259. [PMID: 35506134 DOI: 10.1148/ryct.210259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/03/2022] [Accepted: 02/02/2022] [Indexed: 11/11/2022]
Abstract
Primary mediastinal liposarcoma is a rare, fat-containing malignant lesion that can manifest incidentally with varied imaging appearances. The size and location within the mediastinum can vary among patients. Here, the authors describe the clinical presentation, radiographic characteristics, management, and prognosis in a series of six patients with primary mediastinal liposarcoma. The following case series suggests that even simple-appearing fatty intrathoracic lesions may lead to the development of malignant imaging features. Keywords: Conventional Radiography, CT, MR Imaging, PET/CT, Soft Tissues/Skin, Thorax, Mediastinum ©RSNA, 2022.
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Affiliation(s)
- Gordon S Wong
- School of Medicine and Dentistry (G.S.W.), Department of Imaging Sciences (D.B., S.K.H.), Department of Pathology and Laboratory Medicine (I.Y.C., M.J.V.), and Department of Gastroenterology (R.T.), University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642
| | - David Bass
- School of Medicine and Dentistry (G.S.W.), Department of Imaging Sciences (D.B., S.K.H.), Department of Pathology and Laboratory Medicine (I.Y.C., M.J.V.), and Department of Gastroenterology (R.T.), University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642
| | - Irene Y Chen
- School of Medicine and Dentistry (G.S.W.), Department of Imaging Sciences (D.B., S.K.H.), Department of Pathology and Laboratory Medicine (I.Y.C., M.J.V.), and Department of Gastroenterology (R.T.), University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642
| | - Raymond Thomas
- School of Medicine and Dentistry (G.S.W.), Department of Imaging Sciences (D.B., S.K.H.), Department of Pathology and Laboratory Medicine (I.Y.C., M.J.V.), and Department of Gastroenterology (R.T.), University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642
| | - Moises J Velez
- School of Medicine and Dentistry (G.S.W.), Department of Imaging Sciences (D.B., S.K.H.), Department of Pathology and Laboratory Medicine (I.Y.C., M.J.V.), and Department of Gastroenterology (R.T.), University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642
| | - Susan K Hobbs
- School of Medicine and Dentistry (G.S.W.), Department of Imaging Sciences (D.B., S.K.H.), Department of Pathology and Laboratory Medicine (I.Y.C., M.J.V.), and Department of Gastroenterology (R.T.), University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642
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Suzuki T, Sato T, Hasumi T. Resection of a giant mediastinal atypical lipomatous tumor involving the esophagus. J Surg Case Rep 2021; 2021:rjaa561. [PMID: 33505654 PMCID: PMC7816792 DOI: 10.1093/jscr/rjaa561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/05/2020] [Indexed: 12/02/2022] Open
Abstract
Liposarcoma is one of the common soft tissue tumors but barely arises from the mediastinum. Complete surgical resection with a negative surgical margin is required for the treatment; however, mediastinal liposarcomas tend to be large due to its slow-growing nature. A 57-year-old man was referred to us for having an abnormal mediastinal shadow in a chest X-ray. Computed tomography scanning revealed a giant posterior mediastinal tumor, completely involving the esophagus. Because of the unusual size and location of the tumor, we took a bilateral video-assisted thoracoscopic approach. First, the soft lipomatous compartment of the tumor was dissected from the esophagus and the descending aorta via the left thoracic cavity complete thoracoscopic procedure. Then, the patient was placed in the left lateral position, and the solid part of the tumor was completely resected using 13 cm of right-side thoracotomy. There was no complication or local recurrence in the first 26 months of follow-up.
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Affiliation(s)
- Takaya Suzuki
- Department of Thoracic Surgery, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Taku Sato
- Department of Thoracic Surgery, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Tohru Hasumi
- Department of Thoracic Surgery, National Hospital Organization Sendai Medical Center, Sendai, Japan
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