A minimal invasive approach of esophageal liposarcoma

A pedunculated giant esophageal liposarcoma: a case report and literature review

INTRODUCTION

The majority of esophageal tumors arise from the mucosal layer; only 5 % are of mesenchymal origins. Of the latter, barely 0.5 % are liposarcomas. We present a case of an esophageal liposarcoma with a review of the literature.

CASE REPORT

A 64-year-old male was referred with 5 years of progressive dysphagia. Preoperative evaluation initially suggested a leiomyoma. The polypoid lesion was then resected through a cervical esophagotomy, once endoscopic resection proved to be not feasible. The definitive pathologic diagnosis confirmed a well-differentiated liposarcoma.

LITERATURE REVIEW

Esophageal liposarcomas are very rare and only 40 such cases have been reported in the literature. Most patients were male (80 %), the median age was 62 years (range 38-83 years), and the most common symptom was dysphagia (85 %). Only in two cases was a liposarcoma detected on preoperative biopsy. The most common histological subtype was well-differentiated liposarcoma. Overall, 77.5 % of the patients were successfully treated with surgery, 20 % endoscopically, and 2.5 % were ablated with CO2 laser.

CONCLUSION

Esophageal liposarcoma is an extremely rare tumor. The majority of patients are males; dysphagia is the most common initial symptom, and preoperative biopsy is unreliable. Because these tumors are pedunculated, well-circumscribed, and well-differentiated, they can be safely resected locally. All patients need long-term follow-up as this disease can recur many decades after treatment.

Giant liposarcoma of the esophagus with Li-Fraumeni-like syndrome

Primary esophageal liposarcoma is a rare malignancy, with only 25 cases reported in the English literature. In this report, we present a new case of giant esophageal liposarcoma in a 49-year-old woman with a family history of upper gastrointestinal tract cancer. This was a transmural tumor located in the lower esophagus. Subtotal esophagectomy was successfully performed, and histopathology revealed a well-differentiated liposarcoma. The patient was followed-up for 20 months without recurrence. However, asynchronous ovarian serous adenocarcinoma was found 1 year after the esophageal surgery, and Li-Fraumeni-like syndrome was diagnosed.