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Ataya J, Nahle AA, Hamdar H, Sikaria A, Souleiman Y. Mediastinal liposarcoma: a case report and review of the literature. J Med Case Rep 2023; 17:372. [PMID: 37649065 PMCID: PMC10469449 DOI: 10.1186/s13256-023-04121-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/07/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Mediastinal Liposarcoma (ML) is an exceedingly rare neoplasm, accounting for less than 1% of all liposarcomas. Surgical resection is the most effective therapeutic modality, while adjuvant radiation therapy may be recommended for unresectable tumors. CASE PRESENTATION This case report presents a rare case of a 52-year-old Syrian male patient with well-differentiated mediastinal liposarcoma (ML) who presented with exertional dyspnea, cough, and weight loss. Imaging studies revealed a large tumor causing extrinsic compression on the right lung, as well as compression of the heart and great vessels. CT-guided biopsy confirmed a diagnosis of well-differentiated liposarcoma, and the patient underwent surgical resection. The patient had a rapid postoperative recovery and was discharged on the fourth day post-operation, displaying an excellent postoperative status. The patient was followed up for 3 months postoperatively with no recurrence. CONCLUSION This report highlights the significance of incorporating ML into the differential diagnosis of mediastinal masses, particularly in individuals presenting with exertional dyspnea and weight loss. Furthermore, this report provides a comprehensive review of previously reported cases of ML in the medical literature.
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Affiliation(s)
- Jamal Ataya
- Faculty of Medicine, University of Aleppo, Aleppo, Syria.
| | | | - Hussein Hamdar
- Faculty of Medicine, Damascus University, Damascus, Syria
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Clinicopathological Features of Intrathoracic Liposarcoma-A Systematic Review with an Illustrative Case. J Clin Med 2022; 11:jcm11247353. [PMID: 36555969 PMCID: PMC9781777 DOI: 10.3390/jcm11247353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/03/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Liposarcoma (LPS) is one of the most common soft-tissue sarcomas. However, intrathoracic LPS is rare, as only 1% of all LPS cases are found in the thorax. METHODS A systematic literature review through PubMed and Embase databases was performed. Only eligible case reports and case series reporting intrathoracic LPS in adult patients were included. Kaplan-Meier curves were calculated to evaluate the survival rate of included patients based on the histological subtype of LPS. RESULTS 123 studies reporting 197 patients were included. We added a case of a 69-year-old female patient with recurrent giant intrathoracic LPS. The primary tumor measured 15.1cm × 22.9 cm × 21.9 cm and weighed 3100 g. Six months later, the patient was admitted to the hospital with another intrathoracic tumor measuring 9.5 cm × 9 cm× 1.4 cm. The immunohistochemical studies showed expression of murine double minute 2 (MDM2) antigen in both primary and recurrent tumor cells. CONCLUSIONS Dyspnea, chest pain, and cough were the most common symptoms reported in included studies. Overall, the 5-year survival rate was 62%. The highest survival was observed in well-differentiated LPS patients (80%) and the lowest in myxoid LPS (31%).
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Xie Y, Jing W, Zhao W, Peng R, Chen M, Lan T, Peng H, He X, Chen H, Zhang Z, Zhang H. Primary intrathoracic liposarcomas: A clinicopathologic and molecular study of 43 cases in one of the largest medical centers of China. Front Oncol 2022; 12:949962. [PMID: 36059611 PMCID: PMC9432863 DOI: 10.3389/fonc.2022.949962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Primary intrathoracic liposarcoma is extremely rare, and most published series lack genetic analyses. The aim of our study is to better understand the clinicopathologic and genetic features of these rare lesions. Materials and methods Forty-three primary intrathoracic liposarcomas were identified and most cases were analyzed by systematic genetic studies, including fluorescence in situ hybridization (FISH), whole-exome sequencing (WES), and Sanger sequencing. Results This series included 27 males and 16 females (ratios, 1.68:1) aged 24-73 years (median, 53 years). Tumors mainly occurred in the mediastinum (n=23, 53.5%), followed by pleural cavity (n=16, 37.2%) and lung (n=4, 9.3%). The study included 21 well-differentiated liposarcomas (WDLs), 19 dedifferentiated liposarcomas (DDLs), 2 myxoid pleomorphic liposarcomas (MPLs) and 1 pleomorphic liposarcoma (PL), without identification of myxoid liposarcoma. FISH analysis identified MDM2 amplification in 17 of 18 WDLs (94.4%) and all DDLs (16/16, 100.0%). The MDM2-nonamplified WDL was CDK4-nonamplified but FRS2-amplified. WES and Sanger sequencing found somatic TP53 mutation in the 2 MPLs. Follow-up information was available for 33 of 38 cases (86.8%). Thirteen patients (39.4%) showed no evidence of disease, 10 patients (30.3%) were alive with disease, and 8 patients (24.2%) died of disease. Fourteen cases developed recurrence and 1 with metastasis. Conclusions WDL/DDL was the overwhelming subtype in this location, followed by MPL and PL. Analysis of the FRS2 gene, in combination with MDM2 and other genes of 12q13-15, may more precisely characterize WDL/DDLs. MPL is the most fatal subtype of this site. Further studies are needed to explore the role of TP53 in the pathogenesis of MPL.
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Affiliation(s)
- You Xie
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Wenyi Jing
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Zhao
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Ran Peng
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Min Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Lan
- Department of Pathology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliate to School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Heng Peng
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Xin He
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Huijiao Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhang Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Hongying Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Hongying Zhang,
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Wang H, Li Q, Jiang Q, Yang Y, Liu Y, Gu L, Gong M, Xu G, Chen C. A giant tumor of the mediastinum mixed with thymocytes and adipocytes: a case report. Gland Surg 2021; 10:3163-3166. [PMID: 34926232 DOI: 10.21037/gs-21-651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/17/2021] [Indexed: 11/06/2022]
Abstract
A 17-year-old male was hospitalized for 6 months with chest tightness and shortness of breath. Chest CT showed large mixed density shadow of anterior mediastinum, multiple flaky fat density shadow, left lower lung compression, atelectasis, partial compression of right lung and obvious heart pressure. The patient's symptoms are caused by the compression of the heart and lung by the mediastinal mass. The results of routine examination were normal. After excluding surgical contraindications, the patient underwent resection of a huge mediastinal tumor before median thoracotomy. The operation was smooth and the intraoperative vital signs were stable. The symptoms of chest tightness and shortness of breath disappeared after operation. The size of the tumor tissue removed after operation was about 45×30×25 cm3 and the weight was about 3.7 kg. The pathological diagnosis was thymolipoma. Postoperative reexamination of chest CT showed that the heart and lungs returned to the normal position. In this case, the operation is effective for large thymic tumors, and the symptoms of the patients are significantly relieved. Early diagnosis and surgical treatment are the key to improve the prognosis of patients. In this study, we reported a successful removal of a giant thymolipoma with complete disappearance of symptoms and no serious complications such as myasthenia gravis, aplastic anemia, and vitamin B12 deficiency.
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Affiliation(s)
- Hui Wang
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Qiao Li
- Department of Thoracic Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Qichang Jiang
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yanmiao Yang
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yang Liu
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Longfeng Gu
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ming Gong
- Department of Thoracic Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Gang Xu
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Cheng Chen
- Department of Thoracic Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Elliott DRF, Myers JL, Konopka KE. Thymoliposarcoma with sebaceous differentiation and MDM2 amplification. Pathol Int 2021; 71:633-635. [PMID: 34215023 DOI: 10.1111/pin.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/12/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jeffrey L Myers
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kristine E Konopka
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
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