Korean J Thorac Cardiovasc Surg.  2004 Mar;37(3):286-291.

Extrapleural Pneumonectomy for the Anterior Mediastinal Liposarcoma with Invasion of Pleura and Lung: 1 case report

• Park CS
• Kim YT
• Sung SW
• Kim JH

Abstract

Mediastinum is a very rare primary site of liposarcoma. In general, wide surgical excision with adequate resection margin is the treatment of choice for liposarcoma. We experienced a case of liposarcoma in a 24 year-old male who complained of dyspnea and chest discomfort. Symptoms had been developed a month before admission, and the intensity had been gradually increased. He visited another general hospital, and there he received left closed thoracostomy because hemothorax was suspected. Afterwards, he was transferred to our hospital without a specific diagnosis, on review of outside chest computed tomography film, mass shadow was detected in the mediastinum. For the further evaluation, we checked the chest sonography and chest magnetic resonance imaging. MRI showed 10 cm sized mass contacted with pulmonary artery trunk and left main pulmonary artery. The radiologist strongly suggested sarcoma. On the 4th day after admission, we performed emergent exploratory left thoracotomy for hematoma evacuation because mediastinal shifting progressed and heart rate was increased. Biopsy confirmed that the evacuated materials were extraskeletal myxoid chondrosarcoma, so we performed extrapleural left pneumonectomy including diaphragm and a part of the pericardium. The final pathologic diagnosis was myxoid/round cell liposarcoma. He was discharged without complication and systemic chemotherapy was scheduled to begin 2 month later. During chemotherapy, local recurrence and peritoneal metastasis developed, and he died 10 month after the surgical excision. We report this case with reviewal of literature.

Keyword

Liposarcoma; Mediastinal neoplasm; Pneumonectomy; Chemotherapy

MeSH Terms

Biopsy
Chondrosarcoma
Diagnosis
Diaphragm
Drug Therapy
Dyspnea
Heart Rate
Hematoma
Hemothorax
Hospitals, General
Humans
Liposarcoma*
Lung*
Magnetic Resonance Imaging
Male
Mediastinal Neoplasms
Mediastinum
Neoplasm Metastasis
Pericardium
Pleura*
Pneumonectomy*
Pulmonary Artery
Recurrence
Sarcoma
Thoracostomy
Thoracotomy
Thorax
Young Adult