1
|
Nureta TH, Shale WT, Belete TD. Giant retroperitoneal well differentiated liposarcoma: A case report and literature review. Int J Surg Case Rep 2023; 110:108679. [PMID: 37647755 PMCID: PMC10509818 DOI: 10.1016/j.ijscr.2023.108679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/12/2023] [Accepted: 08/12/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The most prevalent type of primary retroperitoneal tumors is soft tissue sarcoma (STS). Liposarcoma accounts for 40 % of retroperitoneal tumors (Mack, 1995). Retroperitoneal liposarcoma accounts for 12 % to 40 % of all liposarcomas (Vijay and Ram, 2015). They typically present with advanced disease and often carry a poor prognosis. Because of their rarity and anatomic location, these malignant tumors can cause a diagnostic dilemma and present several therapeutic challenges (Vijay and Ram, 2015). CASE PRESENTATION A 48-year-old male patient presented to our gastrointestinal oncology clinic with a 2-year history of abdominal discomfort, weight loss and steadily growing abdominal swelling. A soft, rubbery lobulated mass with a positive "slippage sign" was palpable over all the quadrants of the abdomen. CT scan conclusion was retroperitoneal lipoma with internal enhancing nodular components. During laparotomy, a fatty mass measuring 55*60*22 cm and weighing 14 kg was excised. Histopathologic report showed a well differentiated liposarcoma (WDLS). CLINICAL DISCUSSION Giant retroperitoneal liposarcoma (RPL) is exceedingly rare. Liposarcomas have diverse MRI and CT appearances due to the various subtypes. WDLS are difficult to identify from lipomas before surgery. Histopathology is the only way to provide a reliable diagnosis; therefore en block resection is the recommended approach when malignancy cannot be ruled out. CONCLUSION Although imaging with ultrasound, CT, and MRI can aid in the diagnosis, differentiating WDLS from lipoma pre-operatively can be difficult, and en block resection is the recommended approach when malignancy cannot be ruled out.
Collapse
Affiliation(s)
- Tilahun Habte Nureta
- Jimma University College of Public Health and Medical Sciences, Department of General Surgery, Jimma, Ethiopia; Jimma University College of Public Health and Medical Sciences, GI oncology surgery Unit, Jimma, Ethiopia
| | - Wongel Tena Shale
- Jimma University College of Public Health and Medical Sciences, Department of General Surgery, Jimma, Ethiopia.
| | - Tewodros Deneke Belete
- Jimma University College of Public Health and Medical Sciences, Department of Pathology, Jimma, Ethiopia
| |
Collapse
|
2
|
Okura T, Shirakawa Y, Katsura Y, Yano T, Ishida M, Satoh D, Choda Y, Yoshimitsu M, Kanyu N, Matsukawa H, Idani H, Okajima M, Shiozaki S. Giant esophageal liposarcoma with squamous cell carcinoma resected via the cervical approach: a case report. Surg Case Rep 2022; 8:118. [PMID: 35723761 PMCID: PMC9209544 DOI: 10.1186/s40792-022-01473-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Liposarcoma is one of the most common soft tissue sarcomas, but is extremely rarely found in the esophagus. There have been no reports of esophageal liposarcoma together with superficial carcinoma of the esophagus. Here, we report a patient who underwent complete resection of esophageal liposarcoma with carcinoma via a cervical approach. Case presentation A 66-year-old man was diagnosed with an esophageal tumor 11 years ago, but he left it untreated. He presented to our hospital with progressive dysphagia and appetite loss since the previous year. Esophagogastroduodenoscopy (EGD) showed a large pedunculated submucosal tumor (SMT) originating at the esophageal entrance, extending to the gastroesophageal junction. Additionally, there was a superficial carcinoma on the surface of the SMT, 30 cm from the incisor teeth. Three-dimensional computed tomography (3D-CT) showed a giant elongated intraluminal tumor extending downwards from the cervical esophagus. We diagnosed a giant esophageal polyp accompanied by a superficial carcinoma and performed tumor resection via a cervical approach. The excised specimen consisted of a 23.0 × 8.5 cm polypoid mass. The final diagnosis by histopathological and immunohistochemical examination was well-differentiated liposarcoma and esophageal squamous cell carcinoma. He was discharged on postoperative day 14 with drastic improvement in his swallowing ability. Conclusion We reported an extremely rare case of esophageal liposarcoma together with esophageal squamous cell carcinoma that was successfully resected through a small cervical incision.
Collapse
|
3
|
Ma S, Huang K, Zheng Y. Giant esophageal liposarcoma diagnosed by endoscopic ultrasound. J Med Ultrasound 2022; 30:149-152. [PMID: 35832370 PMCID: PMC9272709 DOI: 10.4103/jmu.jmu_3_21] [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: 01/06/2021] [Revised: 02/22/2021] [Accepted: 05/10/2021] [Indexed: 11/05/2022] Open
Abstract
We report a case of giant well-differentiated esophageal liposarcoma in a Chinese patient. Liposarcoma is a common soft tissue malignant tumor that usually arises in the lower extremities, trunk, and the retroperitoneum, but it is very rare that liposarcoma locates in the gastrointestinal tract, especially in the esophagus. Endoscopic ultrasound could be an efficient tool for preliminary examination. Moreover, the patient underwent combined thoraco-laparoscopic surgery, after reviewing the published articles, this surgery was first applied in the excision of esophageal liposarcoma due to the detailed preoperative information from the ultrasound technique.
Collapse
|
4
|
Ben Safta Y, Souai F, Maatouk M, Zehani A, Mabrouk A, Daldoul S, Sayari S, Haout K, Ben Moussa M. Myxoid esophageal liposarcoma: A case report of a rare tumor. Int J Surg Case Rep 2019; 60:69-71. [PMID: 31207528 PMCID: PMC6580014 DOI: 10.1016/j.ijscr.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/26/2019] [Accepted: 04/03/2019] [Indexed: 11/22/2022] Open
Abstract
Esophagealliposarcoma represent a rare cause of esophagealtumor. We present a case of liposarcomain the low oesophagus treated by surgical resection. There is no conventional treatment of this pathology. The curative treatment requires surgical resection orendoscopic approach for selected tumor.
Introduction Esophageal liposarcoma represent a rare cause of esophageal tumor. According to the literature, since the first case reported in 1983, only 42 cases of esophageal liposarcoma were reported. Presentation of case We present a case of liposarcoma in the lower oesophagus treated by surgical resection. Discussion Liposarcoma in the oesophagus gastrointestinal tract is an uncommon. An analysis of the literature reports 42 cases.In many cases the diagnosis was established in postoperative period.Surgery is the standard treatment including polypectomy, total or subtotal oesophagectomy. Conclusion There is no conventional treatment of this pathology. The curative treatment requires surgical resection or endoscopic approach for selected tumor.
Collapse
Affiliation(s)
- Y Ben Safta
- Surgery A 21 Department, Charles Nicolles hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia.
| | - F Souai
- Surgery A 21 Department, Charles Nicolles hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - M Maatouk
- Surgery A 21 Department, Charles Nicolles hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - A Zehani
- Anatomopathology Departement, Rabta Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - A Mabrouk
- Surgery A 21 Department, Charles Nicolles hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - S Daldoul
- Surgery A 21 Department, Charles Nicolles hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - S Sayari
- Surgery A 21 Department, Charles Nicolles hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - K Haout
- Surgery A 21 Department, Charles Nicolles hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - M Ben Moussa
- Surgery A 21 Department, Charles Nicolles hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| |
Collapse
|
5
|
Weaver HL, Preston SD, Wong HH, Jani P, Coonar AS. Surgical resection of a massive primary mediastinal liposarcoma with cervical extension. Ann R Coll Surg Engl 2018; 100:e22-e27. [PMID: 29182001 PMCID: PMC5838691 DOI: 10.1308/rcsann.2017.0163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2017] [Indexed: 12/15/2022] Open
Abstract
A 73-year-old man was referred for surgical excision of a massive mediastinal and cervical liposarcoma following neoadjuvant chemotherapy. Surgery was performed via a cervical incision, sternotomy and right posterolateral thoracotomy. The tumour arose from the oesophagus, which underwent extensive dissection and was oversewn with pleura after tumour resection. Histology confirmed a completely excised grade 2 de-differentiated liposarcoma with complete macroscopic excision. The patient made an excellent recovery. Oesophageal liposarcomas are rare and, unlike in this case, often extend intraluminally, necessitating oesophagectomy. To our knowledge, this is the largest such tumour found in the literature.
Collapse
Affiliation(s)
- HL Weaver
- Department of Thoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | - SD Preston
- Department of Histopathology, Papworth Hospital NHS Foundation Trust, Papworth Everard,, Cambridge, UK
| | - HH Wong
- Department of Oncology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, UK
| | - P Jani
- Department of ENT Surgery, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, UK
| | - AS Coonar
- Department of Thoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| |
Collapse
|
6
|
Giant Esophageal Liposarcoma in Asymptomatic Young Patient. Cir Esp 2017; 96:381-383. [PMID: 29233581 DOI: 10.1016/j.ciresp.2017.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 09/25/2017] [Accepted: 10/22/2017] [Indexed: 11/23/2022]
|
7
|
Riva G, Sensini M, Corvino A, Garzaro M, Pecorari G. Liposarcoma of Hypopharynx and Esophagus: a Unique Entity? J Gastrointest Cancer 2017; 47:135-42. [PMID: 26875081 DOI: 10.1007/s12029-016-9808-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Liposarcoma is the most common soft tissue sarcoma in adults. It represents approximately 20 % of all mesenchymal malignancies. It most frequently involves retroperitoneum, trunk, and extremities. Hypopharyngeal and esophageal localization of liposarcoma is extremely rare. METHODS We performed a systematic review of literature and reported 26 and 33 cases of hypopharyngeal and esophageal liposarcoma. We analyzed natural history, imaging features, histology, treatment, and prognosis, with a specific focus to similarities and differences between tumors of hypopharynx and esophagus. RESULTS Hypopharyngeal and esophageal liposarcomas have more similarities than differences. Incidence has a peak at 6th and 7th decades. The diagnostic procedures are barium swallow, endoscopic examination, and CT/MR imaging. Well-differentiated liposarcoma represents the most frequent histological subtype. Surgical excision is the main treatment. Endoscopic resection can be useful for pedunculated tumors of hypopharynx and cervical esophagus. Differences between hypopharyngeal and esophageal liposarcoma are represented by local recurrence rate (greater for hypopharyngeal tumors), number of giant tumors, and time to recurrence (greater for esophageal tumors). Finally, liposarcomas of distal esophagus need more extended approaches. CONCLUSIONS Liposarcomas of hypopharynx and cervical esophagus could be considered a unique pathological entity, with similar features and treatment options. Survival rate is dependent on histological type and location. Local recurrence is common, especially for hypopharyngeal liposarcoma, while the risk of lymph node or distant metastasis is very low. Patients should undergo regular examinations to rule out local recurrence, also for a long time, especially for esophageal tumors.
Collapse
Affiliation(s)
- Giuseppe Riva
- 1st ENT Division, Surgical Sciences Department, University of Turin, Via Genova 3, 10126, Turin, Italy.
| | - Matteo Sensini
- 1st ENT Division, Surgical Sciences Department, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Andrea Corvino
- 1st ENT Division, Surgical Sciences Department, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Massimiliano Garzaro
- 1st ENT Division, Surgical Sciences Department, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Giancarlo Pecorari
- 1st ENT Division, Surgical Sciences Department, University of Turin, Via Genova 3, 10126, Turin, Italy
| |
Collapse
|
8
|
Takiguchi G, Nakamura T, Otowa Y, Tomono A, Kanaji S, Oshikiri T, Suzuki S, Ishida T, Kakeji Y. Successful resection of giant esophageal liposarcoma by endoscopic submucosal dissection combined with surgical retrieval: a case report and literature review. Surg Case Rep 2016; 2:90. [PMID: 27589985 PMCID: PMC5010540 DOI: 10.1186/s40792-016-0219-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/16/2016] [Indexed: 12/21/2022] Open
Abstract
Liposarcoma of the esophagus is very rare. We experienced a huge (27.5 × 11.6 cm) liposarcoma of the esophagus. A 73-year-old man presented with severe dyspnea requiring emergency tracheal intubation. Computed tomography and esophagogastroduodenoscopy showed a large submucosal tumor arising from the esophageal entrance and extending intraluminally to the lower esophagus. We successfully performed endoscopic submucosal dissection (ESD) and esophagotomy to remove the tumor, which preserved swallowing and phonation. The final diagnosis by histopathologic and immunohistologic examination was well-differentiated liposarcoma of the esophagus. Treatment by the combination of ESD and esophagotomy can be performed even for a very large tumor. This method preserves deglutition with a lower risk of recurrent laryngeal nerve paralysis than that with esophagectomy.
Collapse
Affiliation(s)
- Gosuke Takiguchi
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Tetsu Nakamura
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yasunori Otowa
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Ayako Tomono
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Shingo Kanaji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Taro Oshikiri
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Satoshi Suzuki
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Tsukasa Ishida
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.,Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, 650-0017, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| |
Collapse
|
9
|
Dowli A, Mattar A, Mashimo H, Huang Q, Cohen D, Fisichella PM, Lebenthal A. A pedunculated giant esophageal liposarcoma: a case report and literature review. J Gastrointest Surg 2014; 18:2208-13. [PMID: 25190025 DOI: 10.1007/s11605-014-2628-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 08/04/2014] [Indexed: 01/31/2023]
Abstract
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.
Collapse
Affiliation(s)
- A Dowli
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston VA Health Care System, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | |
Collapse
|
10
|
Atypical lipomatous tumor mimicking giant fibrovascular polyp of the esophagus: report of a case and a critical review of literature. Hum Pathol 2013; 44:1165-70. [DOI: 10.1016/j.humpath.2012.10.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 10/23/2012] [Indexed: 11/17/2022]
|
11
|
Yo I, Chung JW, Jeong MH, Lee JJ, An J, Kwon KA, Rim MY, Hahm KB. Huge liposarcoma of esophagus resected by endoscopic submucosal dissection: case report with video. Clin Endosc 2013; 46:297-300. [PMID: 23767044 PMCID: PMC3678071 DOI: 10.5946/ce.2013.46.3.297] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 08/29/2012] [Accepted: 09/03/2012] [Indexed: 12/21/2022] Open
Abstract
Liposarcoma is one of the most common soft tissue sarcomas occurring in adults, but it rarely occurs in the gastrointestinal tract and more uncommonly in the esophagus. To the best of our knowledge, there are only 19 reported cases of esophageal liposarcoma in the literature published in English language up to the year 2008, and they were all treated by surgical methods. Here, we report a case of primary liposarcoma of the esophagus which was treated with endoscopic submucosal dissection (ESD). ESD was well tolerated in this patient, suggesting that it may be a therapeutic option for primary esophageal sarcomas.
Collapse
Affiliation(s)
- Inku Yo
- Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Aloraini A, Nahal A, Ferri LE. Transoral endoscopic resection of esophageal liposarcoma. Ann Thorac Surg 2013; 94:e121-2. [PMID: 23098986 DOI: 10.1016/j.athoracsur.2012.04.130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 04/11/2012] [Accepted: 04/20/2012] [Indexed: 11/17/2022]
Abstract
A 63-year-old man presented with a 1-month history of dysphagia. Endoscopy showed the patient had a mass in the cervical esophagus. Multiple biopsy specimens were taken, which were inconclusive for a diagnosis. A positron-emission tomography scan showed a hypermetabolic lesion. A transoral endoscopic approach was used to resect the tumor. Final histologic examination revealed a completely resected low-grade liposarcoma.
Collapse
|
13
|
Rare Cause of Stricture Esophagus-Sarcoma: A Case Report and Review of the literature. Case Rep Gastrointest Med 2011; 2011:192423. [PMID: 22606414 PMCID: PMC3350176 DOI: 10.1155/2011/192423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 07/20/2011] [Indexed: 12/04/2022] Open
Abstract
Adenocarcinoma and squamous cell carcinoma account for the vast majority of oesophageal malignancies. Other malignancies known to occur in the oesophagus include melanoma, sarcoma, and lymphoma. Among the sarcomas, carcinosarcoma is the commonest with both carcinomatous and sarcomatous elements followed by leiomyosarcoma of mesenchymal origin. Other sarcomas reported in the literature are liposarcoma, synovial sarcoma, myxofibrosarcoma, Ewing's sarcoma, granulocytic sarcoma, histiocytic sarcoma, schwannoma rhabdomyosarcoma, and epithelioid sarcoma. We report a case of malignant spindle cell tumour of oesophagus. Sarcomas of esophagus present as a polypoid exophytic soft tissue mass. Our patient presented with a stricture which is a rare presentation. Locally aggressive treatment with surgery is beneficial, and local palliative treatment including radiotherapy is worthwhile.
Collapse
|
14
|
Well-differentiated liposarcoma of the oesophagus: clinicopathological, immunohistochemical and array CGH analysis. Pathol Oncol Res 2010; 17:415-20. [PMID: 21038090 DOI: 10.1007/s12253-010-9322-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 10/20/2010] [Indexed: 01/02/2023]
Abstract
Liposarcoma develops extremely rarely in the oesophagus. Microscopically, it exhibits subtle atypia of H&E-stained features. Accordingly, immunohistochemical features and chromosomal alterations are used for its confirmatory diagnosis. However, cytogenetic analysis has not been performed for oesophageal liposarcoma. We studied chromosomal alterations using array comparative genomic hybridization (CGH), as well as endoscopic, radiological, H&E-stained and immunohistochemical features in the oesophageal well-differentiated liposarcoma of a 67-year-old man. Array CGH analysis revealed the presence of high-level amplifications at chromosomal locations 1p12-1q21.2, 12q13.2-12q15 and 12q21.33-12q23.1. At least 29 genes were highly amplified (log(2) ratio >2), among which CDK4 and MDM2 were the most highly amplified (log(2) ratio >4) and were accepted as major target genes. Moreover, the amplification of AMDHD1, HAL and LTA4H (log(2) ratio = 3.153) was a novel finding. This case suggests the presence of a characteristic profile of gene amplification in well-differentiated liposarcoma of the oesophagus. The amplified genes may be of pathogenic importance for primary oesophageal well-differentiated liposarcoma.
Collapse
|
15
|
Smith MA, Kluck E, Jagannath S, Yang SC. Giant multi-polypoid liposarcoma of the esophagus: an atypical presentation. Ann Thorac Surg 2010; 89:610-2. [PMID: 20103356 DOI: 10.1016/j.athoracsur.2009.06.094] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 06/13/2009] [Accepted: 06/22/2009] [Indexed: 02/09/2023]
Abstract
Liposarcomas of the esophagus are rare with only 19 cases reported in the English literature. We present a giant, well-differentiated liposarcoma of the esophagus with multiple pedunculated polypoid-like growths, which made it radiographically and pathologically noncharacteristic. We discuss the diagnostic dilemmas, clinical and pathologic findings, and surgical treatment.
Collapse
Affiliation(s)
- Maurice A Smith
- Division of Thoracic Surgery, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
| | | | | | | |
Collapse
|
16
|
Ramacciato G, Nigri G, Valabrega S. Clinical Challenges and Images in GI: image 2. A very rare case of dysphagia. Gastroenterology 2008; 135:742,1019. [PMID: 18694751 DOI: 10.1053/j.gastro.2008.07.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Giovanni Ramacciato
- Department of Surgery, Sapienza University of Rome, II School of Medicine, St Andrea Hospital, Rome, Italy
| | | | | |
Collapse
|
17
|
Arteaga-González I, Fernandez ELT, Higa K. A minimal invasive approach of esophageal liposarcoma. J Laparoendosc Adv Surg Tech A 2008; 18:266-70. [PMID: 18373454 DOI: 10.1089/lap.2007.0055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Esophageal liposarcoma is an extremely rare tumor. Different options of treatment have been advocated. We report the case of a 72-year-old-man with a large tumor resected through left cervicotomy with thoracoscopic assistance. Minimal invasive management of these infrequent tumors and the results of the literature are discussed.
Collapse
|
18
|
Xu S, Xu Z, Hou Y, Tan Y. Primary pedunculated giant esophageal liposarcoma: case report. Dysphagia 2007; 23:327-30. [PMID: 18058173 DOI: 10.1007/s00455-007-9130-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Accepted: 09/14/2007] [Indexed: 01/01/2023]
Abstract
Liposarcoma is one of the most common soft tissue sarcomas in adults, but the incidence of esophageal liposarcoma is extremely low. To our knowledge there are only 18 cases of esophageal liposarcoma reported in the English-language literature. Here we report a new case of primary esophageal liposarcoma in a 50-year-old male patient who complained of aggravating dysphagia with intermittent vomiting for 6 months. The tumor was located in the upper esophagus. Polypectomy was performed and histologic examination showed a well-differentiated liposarcoma. Diagnostic and therapeutic tools are discussed and the results of a literature review are discussed.
Collapse
Affiliation(s)
- Songtao Xu
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
| | | | | | | |
Collapse
|
19
|
Mica L, Gianom D, Bode B, Jaklin P, Hollinger A. Rare cause of dysphagy: giant polypoid esophageal well-differentiated liposarcoma. Case Rep Gastroenterol 2007; 1:7-14. [PMID: 21487465 PMCID: PMC3073781 DOI: 10.1159/000104225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Liposarcoma represents one of the most frequent (10–20%) malignant mesenchymal tumors in the adult, affecting mostly the soft tissue of extremities, the trunk or the retroperitoneum. This tumor type occurs exceptionally rarely in the gastrointestinal tract with only few cases described in the literature. In this case we present a 73-year-old male patient who was admitted due to loss of weight, anorexia and postprandial emesis with dysphagy. Gastrographin esophagography failed to make precise diagnostics. CT scan of the upper gastrointestinal tract revealed a large esophageal tumor filling out the whole length of the esophagus. The tumor was removed by parasternocleidomastoidal approach with a stapler. Histopathological examination revealed a well-differentiated liposarcoma (grade I). Well-differentiated liposarcomas are characterised by amplified material of the 12q13-15 chromosomal region, present in the form of giant or ring chromosomes and leading to the overexpression of MDM2 and CDK4 genes. MDM2 and CDK4 proteins can be detected immunhistochemically, which was the case in the reported tumor. Overexpression of these proteins leads to suppression of tumor suppressor genes, leading to increased cell survival.
Collapse
Affiliation(s)
- Ladislav Mica
- Department of Surgery, University Hospital of Zürich, Zürich, Switzerland
| | | | | | | | | |
Collapse
|
20
|
Maruyama K, Motoyama S, Okuyama M, Sasaki K, Sato Y, Hayashi K, Nanjo H, Ogawa JI. Cervical approach for resection of a pedunculated giant atypical lipomatous tumor of the esophagus. Surg Today 2007; 37:173-5. [PMID: 17243042 DOI: 10.1007/s00595-006-3357-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Accepted: 07/13/2006] [Indexed: 11/26/2022]
Abstract
We describe how we removed a giant pedunculated atypical lipomatous tumor, arising in the cervical to upper thoracic esophagus and occupying a region extending from the cervical to the middle thoracic esophagus, through a cervical esophagotomy without thoracotomy or laparotomy. We suggest that if the base of the tumor is located in the cervical portion of the esophagus, and if the tumor is not aggressive, the cervical approach is best, irrespective of the size of the tumor.
Collapse
Affiliation(s)
- Kiyotomi Maruyama
- Department of Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
Abstract
Giant fibrovascular polyps of the esophagus are rare, benign, “tumorlike” lesions that typically present as large pedunculated growths arising in the cervical esophagus. The predominant histologic component of these lesions is variable, often resulting in misdiagnosis. Clinically, these polyps present with nonspecific symptoms and are often undiagnosed or misdiagnosed until they are significant in size. Diagnosis is best made by upper endoscopic evaluation; surgical excision is the definitive treatment. Although rare, asphyxia resulting from obstruction of the glottis is the most serious complication. We describe a case of asphyxiation caused by laryngeal occlusion by a giant esophageal polyp and we provide a review of the literature.
Collapse
Affiliation(s)
- Rachel L Sargent
- Department of Pathology and Laboratory Medicine, Hospital of The University of Pennsylvania, Philadelphia, PA, USA
| | | |
Collapse
|
22
|
Liakakos TD, Troupis TG, Tzathas C, Spirou K, Nikolaou I, Ladas S, Karatzas GM. Primary liposarcoma of esophagus: A case report. World J Gastroenterol 2006; 12:1149-52. [PMID: 16534863 PMCID: PMC4087914 DOI: 10.3748/wjg.v12.i7.1149] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Liposarcoma is the most common soft tissue sarcoma in adult life while esophageal liposarcoma is an extremely rare tumor. In the world literature, only 14 cases of esophageal liposarcomas have been described. We report a 72-year old male patient who was urgently admitted to our hospital for acute epigastric pain with a burning retrosternal sensation, persistent nausea, vomiting and dysphagia. Barium swallow, upper gastrointestinal (GI) endoscopy, esophageal manometry and CT scan, failed to accurately diagnose the lesion. After surgical resection of an esophageal polypoid tumor, the histological examination revealed a well-differentiated grade I liposarcoma. Diagnostic and therapeutic tools were discussed and the results of literature were reviewed.
Collapse
Affiliation(s)
- Theodore D Liakakos
- 3rd Department of Surgery, University of Athens, ATTIKON University General Hospital, Haidari, Athens, Greece
| | | | | | | | | | | | | |
Collapse
|