Primary leiomyosarcoma of the anterior mediastinum

Primary mediastinal leiomyosarcoma are extremely rare tumors, which develop from smooth muscle, usually in the esophagus or main vessels. Very few cases have been reported in the literature and only two of these developed from small vessels in the soft tissue of the anterior mediastinum. We report on a 45-year-old man who presented with a huge anterior mediastinal tumor. The tumor was surgically removed with right thoracotomy and the diagnosis of well-differentiated leiomyosarcoma was established. It probably originated from the anterior mediastinal tissue, so at operation a continuity was not found between the tumor and neighboring structures. This rare and interesting histopathology is discussed and the literature is reviewed.