초록접수 현황
| 16F-093 | 포스터 발표 |
Primary Mediastinal Dedifferentiated Liposarcoma with Pleural Effusion
Ju Sik Yun, Sang Yun Song, Seok Kim, Kook Joo Na
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Korea
Background : Liposarcoma has been subclassified histologically into well-differentiated, myxoid, round-cell, pleomorphic, and dedifferentiated types. Pimary defifferentiated liposarcoma originating in the mediastinum is extremely rare.
Methods : We present a primary mediastinal dedifferentiated liposarcoma with pleural effusion. A 75-year old man who presented with dyspnea was referred to our center with a left-sided, huge mediastinal mass. Computed tomography (CT) scan of the chest showed a 13.2 X 12.2 cm sized, bulky mass with subtle heterogeneous enhancement and large amount of pleural effusion in left hemithorax. The patient underwent closed tube thoracostomy preoperatively. The pleural fluid cytology was negative. So, we scheduled surgical resection.
Results : Extirpation of the tumor was performed with a left posterolateral thoracotomy. The huge tumor appeared to be soft, adipose, and encapsulated. Fibrous adhesion between the tumor and left lower lobe of lung, diaphragm, pericardium without direct invasion. Firstly, the tumor was easily dissected from the left lower lobe and diaphragm. Frozen section examination of the tumor revealed atypical mesothelial proliferation without definite evidence of malignancy. So, the tumor was resected incompletely because of the risk of phrenic nerve injury and an unclear boundary between the tumor and epicardial fat. However, the final pathologic diagnosis was defifferentiated liposarcoma. The patient underwent adjuvant radiotherapy with a total dose of 5000 centigray based on the possibility of residual tumor and was doing well without recurrence or metastasis up to last follow-up.
Conclusion : Although dedifferentiated liposarcomas are extremely rare, they should be considered in the differential diagnosis of patients with mediastinal or pleural mass.
Methods : We present a primary mediastinal dedifferentiated liposarcoma with pleural effusion. A 75-year old man who presented with dyspnea was referred to our center with a left-sided, huge mediastinal mass. Computed tomography (CT) scan of the chest showed a 13.2 X 12.2 cm sized, bulky mass with subtle heterogeneous enhancement and large amount of pleural effusion in left hemithorax. The patient underwent closed tube thoracostomy preoperatively. The pleural fluid cytology was negative. So, we scheduled surgical resection.
Results : Extirpation of the tumor was performed with a left posterolateral thoracotomy. The huge tumor appeared to be soft, adipose, and encapsulated. Fibrous adhesion between the tumor and left lower lobe of lung, diaphragm, pericardium without direct invasion. Firstly, the tumor was easily dissected from the left lower lobe and diaphragm. Frozen section examination of the tumor revealed atypical mesothelial proliferation without definite evidence of malignancy. So, the tumor was resected incompletely because of the risk of phrenic nerve injury and an unclear boundary between the tumor and epicardial fat. However, the final pathologic diagnosis was defifferentiated liposarcoma. The patient underwent adjuvant radiotherapy with a total dose of 5000 centigray based on the possibility of residual tumor and was doing well without recurrence or metastasis up to last follow-up.
Conclusion : Although dedifferentiated liposarcomas are extremely rare, they should be considered in the differential diagnosis of patients with mediastinal or pleural mass.
첨부파일 : Figure.docx
책임저자: Kook Joo Na
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Korea
발표자: Ju Sik Yun, E-mail : jusikyun@gmail.com