[Sarcomatoid pleural mesothelioma presenting as posterior mediastinal tumor with dysphagia]

Case 1: A 46-year-old man with dysphagia, chest pain and cough admitted to our department. Radiological studies demonstrated a solid mass with a maximal diameter of 5cm at the posterior mediastinum. The tumor was resected, then postoperative radiotherapy (60Gy) and chemotherapy were performed. Results of histological and immunohistochemical study showed that the tumor consisted of sarcomatoid mesothelioma. The patient died of recurrence with bone metastasis 6 months after surgery. Case 2: A 76-year-old man with dysphagia, chest pain and cough admitted to our department Radiological studies demonstrated a solid mass with a maximal diameter of 12cm in the posterior mediastinum. accompanied by abundant effusion in the bilateral pleural cavities. The patient underwent open biopsy and histological and immunohistochemical study showed that the tumor consisted of sarcomatoid mesothelioma. The patient died of multiple organ failure on the 1st postoperative day. We report extremely rare cases of sarcomatoid mesothelioma that appeared to be posterior mediastinal tumor before surgery, and discuss the difficulty of diagnosing sarcomatoid mesothelioma with atypical clinical manifestations.