A Case of Giant Mediastinal Liposarcoma of Thymic Origin: A Rare Clinical Entity (original) (raw)
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Asymptomatic giant mediastinal mass: a rare case of thymolipoma
Jornal Brasileiro de Pneumologia, 2009
Thymolipoma is a very rare benign neoplasm of the thymus. We present the case of a 42-year-old male with a massive mediastinal tumor discovered on a chest X-ray after a motorcycle accident. The patient had no complaints, and his physical examination was unremarkable. Chest CT scans revealed a lipomatous mass containing areas of soft tissue density. The patient was submitted to median sternotomy expanded to left anterolateral thoracotomy, resulting in the complete excision of the tumor. The pathological diagnosis was thymolipoma. Thymolipoma usually attains enormous dimensions by the time of diagnosis, and the occasional symptoms are related to compression of adjacent structures. Surgical resection is the treatment of choice and offers the only possibility of cure. The airway deserves special care during anesthesia induction.
Relapsing giant liposarcoma originating in the chest wall
Turkish Journal of Medical Sciences, 2009
Soft tissue sarcomas originating in mesenchymal tissue are rarely seen and account for only 1% of malignant tumors (1). Malignant fibrous histiocytomas and liposarcomas are the most common soft tissue sarcomas, with liposarcomas accounting for 20% (2). Liposarcomas are usually seen in the retroperitoneal region and in extremities, but can be seen in the head, neck, inguinal region, and chest wall less frequently. Involvement of the chest wall is observed the least, with a frequency of 3% (3). Two-thirds of the patients are over 40 years of age. Complete surgical resection is the recommended therapy. Radiotherapy can be used palliatively for prevention of early recurrences (4). In this report, a relapsing giant liposarcoma weighing 9 kg and with a diameter of 50 cm is discussed with the relevant data in the literature. Case Report An 80-year-old male was admitted with fatigue, weight loss, and a swelling originating in his left chest wall and extending to his left axilla and back. Ten years before, because of liposarcoma, the patient had been operated on 4 times at different centers. He had hypertension and congestive heart failure, and his physical examination revealed a hard, large mass extending from the left front chest wall to the left axillary region and back with a transverse diameter of 65 cm (Figure 1). Chest radiography showed a nonspecific intensification on soft tissue and effacement in basilar regions of the left hemithorax. On thoracoabdominal computerized tomography (CT) scan with opaque material, a giant mass was seen extending towards the fossa axillaris and left breast at the left thoracal level. The mass was heterogeneous and rich in fat tissue (Figure 2). No finding on chest 825
Enbloc resection of the largest thymic liposarcoma: A case report with literature review
Annals of Medicine and Surgery, 2020
Introduction: Liposarcoma is the most common soft tissue tumor which is commonly found in the retroperitoneal region. This kind of tumor is usually well-differentiated with low to no potential to metastasize. Thymoliposarcomas are extremely rare tumors that are difficult to diagnose and differentiate from thymomas and other benign conditions. Presentation of a case:This report presents a case of a 46-year-old male patient with dyspnea, generalized fatigue and non-specific chest pain caused by a giant anterior mediastinal mass. Computed tomography scan revealed a large mass in the anterior mediastinum. CT guided biopsy was consistent with thymolipoma. The tumor was surgically resected. The histological analysis of the tumor revealed thymoliposarcoma. Discussion:Thymoliposarcoma usually presents with non-specific symptoms. The mean age of the diagnosis is 55.8 years old with a slight predominance in males. The corner stone of the treatment remains surgical excision of the tumor while the role of adjuvant therapy is not well documented.
Successful Thoracoscopic Resection of a Large Mediastinal Liposarcoma
The Annals of Thoracic Surgery, 2011
We report a case of a rare, large mediastinal liposarcoma diagnosed in a 74-year-old woman after a syncopal episode. Chest roentgenogram and computed tomographic scan showed a large mass occupying most of the right chest and abutting the great vessels and pericardium. A thoracoscopic approach was used for exploration and surgical excision of this large mediastinal mass. Despite the large size of the mass, the thoracoscopic approach offered excellent visualization of all the mass attachments and required only a small extension of the access incision for tumor removal. The mass was a well-differentiated liposarcoma, which was completely resected with clear margins. The patient remains disease-free almost 3 years after the resection.
West Indian Medical Journal, 2016
Background: Thymolipoma is a rare benign tumor of the mediastinum, accounting for 2-9 % of all thymic tumors. Although many case reports have been published in the literature, few studies have analyzed the clinical and radiological features and the surgical outcomes of this tumor. Aim: To evaluate the clinical and radiological features and the surgical outcomes of the patients with thymolipoma. Methods: We reviewed the records of pathology department from the beginning of 2005 to the end of 2013. Results: We identified 11 patients with thymolipoma. There were eight male and three female patients. Their ages ranged from 27 to 72 years, with mean age of 40 years. All patients described pulmonary or extrapulmonary symptoms. Two patients (18.2 %) had myasthenia gravis. Chest X-ray was normal in four patients. Computed tomography of the thorax revealed a mass located in the anterior mediastinum in all patients. It showed fat attenuation in four of 11 patients (36.4 %). Thymectomy was per...
Unusual Anterior Mediastinal Tumors Treated at a Tertiary Thoracic Center: A Case Series Analysis
Cureus, 2021
Several tumors arise from different structures within the mediastinum. Although each type of mediastinal tumor has a predilection for a specific compartment, the progression of growth from one compartment to another can occur. The anterior mediastinum is the site of several tumors that pose interesting diagnostic and therapeutic challenges to thoracic surgeons. The anterior mediastinum is the seat of the majority of neoplastic growths within the mediastinum. Thymomas and lymphomas are the most common pathologies of the anterior mediastinum. Tumors of mesenchymal origin (hemangioma, lymphangioma, lipomas) and their malignant counterparts may occur in any of the mediastinal compartments. Less common tumors of the anterior mediastinal compartment are ectopic thyroid and parathyroid tumors, germ cell tumors, mesenchymal origin tumors, hemangiomas, and cervicomediastinal hygromas. Most of the mediastinal growths usually remain clinically silent until they become large and cause compressive symptoms. Here, we present a case series of five anterior mediastinal tumors consisting of solitary benign teratoma, fibrous benign tumor, malignant fibrosarcoma, hamartomatous chondroma, and malignant thymoma.
Giant mediastinal teratoma found during surgery after thoracic trauma
Most mediastinal tumors are incidentally diagnosed because they are asymptomatic. The aim of this paper is to report on the case of a 29-year-old male patient, who had an increase in cardiac area after blunt thoracic trauma. He was submitted to thoracotomy when a large mediastinal mass was found. The histopathological diagnosis was a mature mediastinal teratoma.
Bulky Anterior Mediastinal Tumours: An Initial Experience in a Thoracic Oncology Unit
2020
Anterior mediastinum is the seat of majority of neoplastic growths arising from the thymus, fat, nerves, lymph nodes, and rarely thyroid and parathyroid. They usually remain clinically silent until late when they become huge and cause compressive symptoms or present after they complicate. Intra-thoracic fibromas are mesenchymal neoplasms that are exceedingly uncommon. There has been a persistent confusion regarding the nomenclature of this tumour which has included pleural fibroma, benign mesothelioma, submesothelial fibroma. benign mediastinal masses can be treated very effectively by various surgical approaches including VATS, thoracotomy or median sternotomy depending upon their location, size and surgical expertise. Postoperative outcome is usually fair as seen in our cases and recurrence is hardly evident. Malignant entities require a more sophisticated approach based on histopathology, ease of resectability and patient’s factor
Thoracoscopic resection of a giant teratoma compressing the right heart
Interactive cardiovascular and thoracic surgery, 2013
A 26-year old female had an incidental finding of a cystic mediastinal mass (10.8 × 9.4 × 10.0 cm) in the inferior-anterior mediastinum. It had compressed the superior vena cava, right atrium and right ventricle, and additional imaging studies could not exclude right heart involvement. She underwent exploration via right thoracoscopy (video-assisted thoracoscopy), and the right groin vessels were isolated for bypass, if needed. Examination of the mass revealed its extrapericardial origin from the thymus. Complete resection was achieved with minimally invasive techniques through a 2.5-cm incision using a three-port approach. She was discharged on postoperative day one. The interdisciplinary planning and cooperation in this case avoided thoracotomy or sternotomy and allowed for a safe and complete minimally invasive resection.