Huge mediastinal liposarcoma resected by clamshell thoracotomy: a case report

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pathology

Background:

• Liposarcoma is the most common soft tissue sarcoma.
• Mediastinal liposarcomas require complete excision due to rapid growth and recurrence.
• Surgical feasibility for large mediastinal tumors must be assessed.

Purpose of the Study:

• To report a case of a huge mediastinal liposarcoma.
• To evaluate the efficacy of clamshell thoracotomy for resection.

Main Methods:

• A 64-year-old male with a 36 cm anterior mediastinal tumor underwent biopsy, confirming atypical lipomatous tumor.
• En bloc resection was performed using a clamshell incision.
• The left brachiocephalic vein was resected due to tumor encasement.

Main Results:

• The 3500g tumor was diagnosed as dedifferentiated liposarcoma with non-adipocytic sarcoma.
• The patient remains disease-free 20 months post-operation.
• Clamshell incision provided an excellent surgical field.

Conclusions:

• Clamshell thoracotomy is a safe and effective approach for resecting huge mediastinal liposarcomas.
• Complete surgical excision is achievable for these challenging tumors.