Well-Differentiated Liposarcoma (Atypical Lipomatous Tumor) Presenting as an Esophageal Polyp

Giant liposarcoma of esophagus: a rare case report

BACKGROUND

Liposarcoma is a malignant mesenchymal tumor that most commonly involves the retroperitoneum and lower extremities. However, liposarcoma of esophagus has been rarely reported in the literature.

CASE PRESENTATION

We report a case of a 46-year-old man with complaint of intermittent dysphagia for 6 years, accompanied with paroxysmal vomiting of pedicled tumor to the mouth. Imaging studies showed a huge mixed density lesion in the middle esophageal lumen. Surgical resection of the tumor was performed through an external cervical approach. Microscopically, the tumor was composed of mature adipocytes in normal adipose tissue prominently intersected by sparsely cellular fibrous septa containing atypical, enlarged spindle cells with hyperchromatic nuclei. Immunohistochemically, the tumor cells were positive for Vimentin, S-100, CD34 and MDM2. Besides, fluorescence in situ hybridization (FISH) analysis indicated the presence of amplification involving MDM2 gene. The patient was diagnosed as having esophageal well-differentiated liposarcoma and recovered well after the operation.

CONCLUSIONS

Esophageal liposarcoma is an extremely rare tumor. Due to the nonspecific clinical manifestation and lack of experience, it is challenging to make a clear diagnosis before operation. Definite diagnosis of esophageal liposarcoma depends on histopathology, immunohistochemistry and molecular analysis.

Thoracoscopic resection of a huge esophageal dedifferentiated liposarcoma: A case report

BACKGROUND

Esophageal liposarcoma is a rare malignant tumor and an esophageal dedifferentiated liposarcoma (DDL) is extremely rare. There are no reports on the treatment of DDL by thoracoscopic surgery.

CASE SUMMARY

A 38-year-old woman presented with dysphagia and dyspnea. Imaging examination showed a large mass in the posterior mediastinum. The patient also developed respiratory failure and it was unclear whether this was caused by a mass from inside or outside the esophagus. We decided to perform thoracoscopic exploration to relieve the obstruction caused by tracheal compression. The upper segment of the esophagus was split longitudinally, and most of the mass could be removed from the esophageal lumen to the thoracic cavity. The pedicle was excised by linear cutting closers under mirrors. Little residual mass was visualized by gastroscopy. The mucous and muscular layers were closed by interrupted sutures. Pathological examination showed that the mass was a DDL. The patient did not have any dysphagia or dyspnea 2 wk postoperatively and refused any further treatment. Computed tomography and esophagoscopy did not find any recurrence at up to 20 mo postoperatively.

CONCLUSION

Thoracoscopy can be used to treat large esophageal masses.