title: Successful resection of recurrent mediastinal liposarcoma using preoperative evaluation of organ invasion by four-dimensional computed tomography.
abstract: We report the case of a 64-year-old woman with recurrent mediastinal dedifferentiated liposarcoma. She had undergone surgical resection twice. Subsequently, on regular follow-up visits, chest computed tomography demonstrated a third local recurrence of the tumor with invasion into adjacent intrathoracic organs. Adhesion of the heart to the anterior chest wall through a pericardial defect that had been inadvertently created at the second operation was suspected. We decided to use a thoracoabdominal approach with four-dimensional computed tomography (4DCT) for preoperative guidance. The patient had also undergone MRI; however, the result was equivocal regarding adhesion of intrathoracic organs. The use of 4DCT enabled successful en bloc resection of the tumor. Results of the pathology examination showed complete resection of a dedifferentiated liposarcoma. The patient's postoperative course was uneventful, and she was discharged on postoperative day 19.
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawahara-chyo, Shyogoin, Sakyo-ku, Kyoto, 606-8507, Japan.|Department of Thoracic Surgery, Nishi-kobe Medical Center, Hyogo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Fujimoto
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawahara-chyo, Shyogoin, Sakyo-ku, Kyoto, 606-8507, Japan. satomasa@kuhp.kyoto-u.ac.jp.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Thoracic Surgery, Nishi-kobe Medical Center, Hyogo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Miyata
authors.affiliation: Department of Cardiovascular Surgery, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Minakata
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawahara-chyo, Shyogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Omasa
authors.affiliation: Department of Radiology, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawahara-chyo, Shyogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D005260:Female; D056973:Four-Dimensional Computed Tomography / Q000379:methods; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008080:Liposarcoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000601:surgery*; D010496:Pericardium / Q000293:injuries; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011300:Preoperative Care / Q000379:methods; D035441:Thoracic Wall / Q000000981:diagnostic imaging
keywords: Dedifferentiated liposarcoma; Four-dimensional computed tomography; Mediastinal liposarcoma; Recurrence