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Primary Mediastinal Liposarcoma

Ouadnouni Y, Serraj M, Ghalimi J, Lakranbi M, Smahi M

University Hospital Hassan II, Fez, Morocco

Correspondence to: Dr Yassine Ouadnouni, P.O Box 31052 Fez, Morocco. Email: ouadnouni2@yahoo.fr

 

Summary

Liposarcomas (LPS) are uncommon and present diagnostic and therapeutic difficulties. Computed tomography and magnetic resonance imaging allow for a diagnostic orientation, allowing differentiated from other more common tumors of the anterior mediastinum. Surgery is the treatment of choice and has the advantage of being curative. We report a case of well-differentiated liposarcoma of the anterior mediastinum.

Key Words: Liposarcoma, Mediastinum, Surgery

Introduction

Liposarcomas (LPS) are very rare tumors especially in ther mediastinum. They are characterized by a high histologic and prognostic heterogeneity and present lots of diagnostic challenges because of their typical clinical latency, the absence of specific radiological data, but also therapeutic challenges because of the lack of a consensus outside the classic cancer surgery even in the face of recurrence.We report a case of well-differentiated liposarcoma of the mediastinum

 

Case Report

A 52 years old man of general good health presented with a two months history of chest pain and dyspnea. A chest radiograph was unremarkable. However a chest computed tomography (CT) scan showed an anterior mediastinal tumor of tissue and fatty components with minimal bilateral pleural and pericardial effusions. The patient underwent an anterior mediastinotomy and the mass biopsied. Histology confirmed the lesion was a liposarcoma. After staging, and in consultation with the Thoracic Oncology Group, a surgical resection of the mass, the thymus and involved surrounding structures including the pericardium, the right and left mediastinal pleura, the innominate trunk and left ventral segment of the right upper lobe was performed by sternotomy. Histological analysis of the surgical specimen that measured 14cm x 11cm x 3.5 cm and weighed 191g, found a tumor process of fatty differentiation with immunologic labeling; MDM2 positive, confirming a well-differentiated liposarcoma grade 1 (according FNLCC). The immediate post-operative period was marked by an infection of the surgical site without mediastinitis. This was managed locally and with antibiotics. Adjuvant radiotherapy is ongoing. Written informed consent was obtained from the patient for the publication of this case report and accompanying images.

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Discussion

Sarcomas are rare mesenchymal tumors representing less than 1 % of all malignancies. Liposarcomas are however, one of the most common subtypes of adult soft tissue s