2013 Volume 53 Issue 6 Pages 767-770
Background. Liposarcoma originating in the thoracic cavity is uncommon. Case. A 70-year-old male presented at our hospital with general malaise and a slight fever. Chest radiography revealed a large tumor in the mediastinum. Computed tomography (CT) showed a mass measuring 13 cm in diameter in the anterior mediastinum. A CT-guided needle biopsy of the anterior mediastinal mass was performed. An examination revealed that the tumor was characterized pathologically by the presence of non-epithelial spindle cells, indicating a sarcoma. The tumor rapidly enlarged over the following month. Surgery was planned, and tumor extirpation was performed with a hemi-clamshell incision (upper median sternotomy and left fourth intercostal thoracotomy). The tumor was found to be smoothly-shaped, and covered by a fibrous capsule and appeared to have originated from the anterior mediastinum. It had not invaded the surrounding structures, such as the lungs and large vessels. An immunostaining revealed dedifferentiated liposarcoma. Six months after surgery, the patient experienced recurrence of the liposarcoma with pleural dissemination. Conclusions. Dedifferentiated liposarcoma is associated with a poor prognosis and carries a high risk of local recurrence and distant metastasis. Patients diagnosed with this tumor should be closely followed to identify any new lesions at an early stage.
