title: A pedunculated giant esophageal liposarcoma: a case report and literature review.
abstract: BACKGROUND
  The majority of esophageal tumors arise from the mucosal layer; only 5 % are of mesenchymal origins. Of the latter, barely 0.5 % are liposarcomas. We present a case of an esophageal liposarcoma with a review of the literature.
  
  
  METHODS
  A 64-year-old male was referred with 5 years of progressive dysphagia. Preoperative evaluation initially suggested a leiomyoma. The polypoid lesion was then resected through a cervical esophagotomy, once endoscopic resection proved to be not feasible. The definitive pathologic diagnosis confirmed a well-differentiated liposarcoma.
  
  
  METHODS
  Esophageal liposarcomas are very rare and only 40 such cases have been reported in the literature. Most patients were male (80 %), the median age was 62 years (range 38-83 years), and the most common symptom was dysphagia (85 %). Only in two cases was a liposarcoma detected on preoperative biopsy. The most common histological subtype was well-differentiated liposarcoma. Overall, 77.5 % of the patients were successfully treated with surgery, 20 % endoscopically, and 2.5 % were ablated with CO2 laser.
  
  
  CONCLUSIONS
  Esophageal liposarcoma is an extremely rare tumor. The majority of patients are males; dysphagia is the most common initial symptom, and preoperative biopsy is unreliable. Because these tumors are pedunculated, well-circumscribed, and well-differentiated, they can be safely resected locally. All patients need long-term follow-up as this disease can recur many decades after treatment.
authors.affiliation: Division of Thoracic Surgery, Brigham and Women's Hospital, Boston VA Health Care System, Harvard Medical School, Boston, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Dowli
authors.forename: A
authors.initials: A
authors.lastname: Mattar
authors.forename: H
authors.initials: H
authors.lastname: Mashimo
authors.forename: Q
authors.initials: Q
authors.lastname: Huang
authors.forename: D
authors.initials: D
authors.lastname: Cohen
authors.forename: P M
authors.initials: PM
authors.lastname: Fisichella
authors.forename: A
authors.initials: A
authors.lastname: Lebenthal
mesh_terms: D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016629:Esophagectomy / Q000379:methods; D004945:Esophagoscopy; D006801:Humans; D008080:Liposarcoma / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged