title: Successful resection of a massive mediastinal liposarcoma that rapidly extended into the entire left thoracic cavity: report of a case.
abstract: Primary mediastinal liposarcomas are rare malignancies, comprising fewer than 1% of all mediastinal tumors. We herein report a radical resection of a massive liposarcoma arising from the anterior mediastinum. A 63-year-old male patient presented with a 4-week history of dyspnea that had worsened over the previous several days. The patient had also experienced hoarseness for 2 weeks. Chest X-ray and computed tomography revealed a huge tumor occupying the entire left thoracic cavity. Anesthesia was induced when the patient was in the left semilateral position. The patient was moved into the right lateral position after initially stabilizing anesthesia with separate lung ventilation. The fourth rib was initially resected for thoracotomy, but there was no clearance between the tumor and the adjacent mediastinal structures, and two more ribs were therefore removed. The tumor had not invaded the other structures such as the chest wall, lung, or mediastinum. To reduce the tumor blood flow, the left internal mammary artery was ligated before the tumor was resected en bloc. The tumor was diagnosed as a liposarcoma arising from the thymus. The patient remains alive with no evidence of disease recurrence at 22 months after the operation.
authors: Department of Surgery, Thoracic Surgery Division, Ehime University Graduate School of Medicine, Shitsukawa, Ehime 791-0295, Japan. kashu@m.ehime-u.ac.jp
authors: Yasuaki
authors: Y
authors: Kashu
authors: Shungo
authors: S
authors: Yukumi
authors: Nobuo
authors: N
authors: Tsunooka
authors: Kazufumi
authors: K
authors: Tanigawa
authors: Motoki
authors: M
authors: Arakane
authors: Hiromichi
authors: H
authors: Nakagawa
authors: Kanji
authors: K
authors: Kawachi
mesh_terms: D004638:Emergency Treatment; D006801:Humans; D008080:Liposarcoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D035423:Thoracic Cavity / Q000473:pathology / Q000601:surgery*; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed