Dedifferentiated Mediastinal Liposarcoma: A Case Report.

Liposarcoma is the most common soft tissue sarcoma type in adults, originating mainly from the retroperitoneum and lower extremities. Mediastinal liposarcomas constitute an extremely rare clinical entity of mesenchymal origin. Among subtypes, dedifferentiated liposarcoma is characterized by poor survival, but little is known about its biological behavior. We present the case of a 78-year-old male patient who presented with vague symptoms, predominantly dyspnea and chest pain. Imaging revealed a large mediastinal mass and surgical resection was performed in a piecemeal manner due to the inability to achieve a microscopically negative surgical margin (R0 resection) for the residual tumor. Histological examination confirmed the diagnosis of dedifferentiated liposarcoma. The patient's postoperative course was uneventful, with discharge from the hospital on the 10th postoperative day. However, local recurrence was detected after two months and the patient died four months after the operation. The present case report highlights the importance of radical excision for the prevention of local recurrence and the presentation of histological characteristics of this tumor. Radical surgical resection remains the fundamental treatment, while chemo and radiotherapy may have an adjuvant role. In cases of inability to obtain negative margins, surgical debulking can offer symptomatic relief.

Mediastinal liposarcoma: a case report and review of the literature.

BACKGROUND: Mediastinal Liposarcoma (ML) is an exceedingly rare neoplasm, accounting for less than 1% of all liposarcomas. Surgical resection is the most effective therapeutic modality, while adjuvant radiation therapy may be recommended for unresectable tumors. CASE PRESENTATION: This case report presents a rare case of a 52-year-old Syrian male patient with well-differentiated mediastinal liposarcoma (ML) who presented with exertional dyspnea, cough, and weight loss. Imaging studies revealed a large tumor causing extrinsic compression on the right lung, as well as compression of the heart and great vessels. CT-guided biopsy confirmed a diagnosis of well-differentiated liposarcoma, and the patient underwent surgical resection. The patient had a rapid postoperative recovery and was discharged on the fourth day post-operation, displaying an excellent postoperative status. The patient was followed up for 3 months postoperatively with no recurrence. CONCLUSION: This report highlights the significance of incorporating ML into the differential diagnosis of mediastinal masses, particularly in individuals presenting with exertional dyspnea and weight loss. Furthermore, this report provides a comprehensive review of previously reported cases of ML in the medical literature.

Myxomatous Liposarcoma of the Mediastinum: A Review of the Literature.

Myxomatous liposarcoma is an extremely rare type of mediastinal tumour that manifests in a manner comparable to other lung pathologies. Chest pain, shortness of breath, and dysphagia are the common presenting complaints. Radiological examinations or postoperative histological examinations provide the majority of the diagnostic evidence. The cornerstone of therapy consists of surgery and sometimes chemotherapy. Those who are afflicted have a better chance of experiencing favourable outcomes if they receive a diagnosis and treatment quickly.

Multiple surgical excision for recurrent primary mediastinal liposarcoma.

Liposarcoma is one of the most common soft tissue malignancies, occurring mostly in the extremities and retroperitoneal cavities, and occasionally in the mediastinum of the thoracic cavity. Here, we present a patient undergoing four operations over a period of 33 years because of repeated recurrence of mediastinal liposarcoma. A 34-year-old woman underwent her first surgery for mediastinal liposarcoma in 1986. Ten years later, a recurrent tumour was found during follow-up. The patient underwent a second operation for complete excision. The pathology was liposarcoma, partly myxoid and partly dedifferentiated. The patient remained tumour-free for 22 years, until one year ago, when a third operation was performed to resect the recurrent tumour which was myxoid liposarcoma. Unfortunately, upon computed tomography imaging three months later a fatty mass was spotted which increased rapidly in size. The patient underwent further surgery to achieve radical excision of the recurrent liposarcoma. Postoperative recovery was uneventful, and a follow-up examination showed no recurrence to date. For mediastinal liposarcoma, surgical removal is the treatment of choice. Considering that the tumour is prone to recurrence, the lesion should be removed as thoroughly as possible in the first operation. If the tumour recurs repeatedly, multiple resections are beneficial to patient survival on most occasions.

Giant mediastinal liposarcoma resected by median sternotomy: a case report.

Liposarcoma is a type of common tumor in soft tissue, but liposarcoma originating in the mediastinum is rare. Here, we report a case of the anterior mediastinal liposarcoma resected by a median sternal incision and complicated with reexpansion pulmonary edema after surgery. A 68-year-old female patient with chest tightness and shortness of breath for more than 2 years, recently presents with increased chest tightness and shortness of breath, as well as right upper extremity and lower back pain. Enhanced chest CT scan showed an uneven and low-density mass in the anterior mediastinum with clear border. Most of the mass showed fat density, the anterior part of the mass was solid, and the liquid density was seen in the pericardial cavity. Surgery was performed with a median sternal incision, and part of the pericardium and the innominate vein wall were removed during the removal of the entire liposarcoma. The size of the tumor was about 20 cm × 10 cm × 8 cm. The patient developed a reexpansion pulmonary edema after the giant mediastinal liposarcoma resection, but she was discharged successfully on the 10th postoperative day with the treatment by anti-glucocorticoids and diuretics. Postoperative pathology showed well-differentiated liposarcoma. Now within the half-year follow-up, the patient remained well and there is no sign of recurrence. Median sternotomy is considered to be a good surgical procedure for giant mediastinal liposarcomas. Attention should be given to prevent reexpansion pulmonary edema after surgery.

Incidental dedifferentiated mediastinal liposarcoma on F-18-fluciclovine PET/CT.

Fat-containing mediastinal masses, particularly mediastinal liposarcomas, are rare neoplasms that can grow to large sizes before becoming symptomatic and may be incidentally found on radiology examinations. In this case report, a 67-year-old male with a history of prostate cancer status post prostatectomy presented for an F-18-fluciclovine PET/CT for a rising, clinically detectable PSA and indeterminate pelvic lymph nodes seen on multiparametric MRI of the prostate. No local tumor recurrence or metastatic disease from prostate cancer was identified, but the PET/CT demonstrated a mixed soft tissue and fat density prevascular (anterior) mediastinal mass with low-level radiotracer uptake. Following surgical consultation and resection, the final pathology revealed a dedifferentiated mediastinal liposarcoma. The case presented describes the appearance of an uncommon fat-containing mediastinal mass and describes several other fat-containing mediastinal masses that are important for radiologists to recognize in order to formulate accurate differential diagnoses and ensure appropriate further management for patients. Additionally, this case demonstrates that the radiotracer F-18-fluciclovine is not specific for prostate cancer, and its uptake can be seen with other entities such as in this case of sarcomatous malignancy.

Mediastinal liposarcoma: a rare visceral mediastinal tumour.

Liposarcoma is the second most common type of soft tissue malignancy in adults. They are malignant tumours with a mesenchymal origin. Mediastinal liposarcoma accounts for <1% of mediastinal tumours and 2% of liposarcoma. We report a patient with mediastinal liposarcoma who presented with cardiac tamponade, 25 years after the initial liposarcoma in the popliteal fossa.

An unusual case of recurrent huge primary mediastinal dedifferentiated liposarcoma.

INTRODUCTION: Primary mediastinal dedifferentiated liposarcoma is an extremely rare malignant mesenchymal neoplasm composed of lipogenic tissue. It can be huge enough to compress heart and surrounding organs leading to clinical symptoms. PRESENTATION OF CASE: We present a case of huge primary mediastinal dedifferentiated liposarcoma in a 54-year-old man, confirmed by immunohistochemistry staining, who received surgical removal. However, six months later, the tumor recurred, and the patient underwent chemotherapy for 6 cycles resulting in stable disease. Six months after the last visit, the tumor showed no sign of recurrence anymore. DISCUSSION: Among the various subtypes, the dedifferentiated mediastinal liposarcoma is the least found type of liposarcoma and often leads to misdiagnosis. Challenges occurred not only in diagnosis but also in treatment since it frequently grows back and chemotherapy may be needed after surgery. CONCLUSION: This is a highly rare case of huge mediastinal liposarcoma that recurred after surgery and gave a satisfying outcome after chemotherapy.

Dedifferentiated primary mediastinal liposarcoma mimicking a thymic tumor.

Mediastinal tumors are heterogeneous and the diagnosis depends on their location in the mediastinum. The most frequent tumors are germinal tumor, lymphoma and thymoma. The clinical and radiological aspects are often not sufficient to orient the diagnosis and biopsy is necessary to confirmed it. Here, we present a rare case of an anterior mediastinal mass incidentally detected in a 63 years old man during assessment for asthma. The lesion was presumptively diagnosed as a thymic epithelial tumor based on location and radiological characteristics. Surgical biopsy revealed a primary dedifferentiated mediastinal liposarcoma with multiple lung metastases.

Recurrent primary mediastinal liposarcoma: A case report.

Primary mediastinal liposarcomas are extremely rare. The current study reports the case of a 63-year-old man presenting with a primary liposarcoma arising from the posterior mediastinum. The patient reported a 6-month history of chest pain with increasing dyspnea for 2 months. Enhanced computed tomography revealed a 10×16-cm mass in the posterior mediastinum. Other physical examinations were normal. Radical resection was performed under the agreement of patient. Subsequent pathological analysis indicated a liposarcoma. The patient recovered and was successfully discharged. However, at a follow-up examination 12 months after surgery, recurrence was identified in the anterior mediastinum. Therefore, the patient underwent surgery. The postoperative course was uneventful, however, there was evidence of disease recurrence 2 years after the second surgery. The patient refused any treatment and succumbed after 3 months.

Successful resection of recurrent mediastinal liposarcoma using preoperative evaluation of organ invasion by four-dimensional computed tomography.

We report the case of a 64-year-old woman with recurrent mediastinal dedifferentiated liposarcoma. She had undergone surgical resection twice. Subsequently, on regular follow-up visits, chest computed tomography demonstrated a third local recurrence of the tumor with invasion into adjacent intrathoracic organs. Adhesion of the heart to the anterior chest wall through a pericardial defect that had been inadvertently created at the second operation was suspected. We decided to use a thoracoabdominal approach with four-dimensional computed tomography (4DCT) for preoperative guidance. The patient had also undergone MRI; however, the result was equivocal regarding adhesion of intrathoracic organs. The use of 4DCT enabled successful en bloc resection of the tumor. Results of the pathology examination showed complete resection of a dedifferentiated liposarcoma. The patient's postoperative course was uneventful, and she was discharged on postoperative day 19.

Primary mediastinal pleomorphic liposarcoma involving the superior vena cava.

Primary mediastinal liposarcomas are extremely rare. They are primarily diseases of adults; however, they may be encountered in children. They are characterized by their large size and variable histologic subtypes, which correlate with clinical behavior and prognosis. Although the overall prognosis is poor, it is dependent upon the histologic subtype and completeness of surgical excision. Herein we present a case of a primary mediastinal pleomorphic liposarcoma in a 49-year-old male who received an en-bloc resection and superior vena cava replacement with Gortex graft. The patient has been disease-free after surgery for over 14 months.

Primary Mediastinal Myxoid Liposarcoma

In this study, we report an extremely rare case of liposarcoma which arises primarily in mediastinum. The patient appeared to have progressive dyspnoea and prolonged cough for a duration of one year. Chest radiograph and Computed Tomography (CT) of the thorax revealed a large right mediastinal mass with fatty component. It was confi rmed to be primary liposarcoma on histopathological examination.