Esophageal fistula after resection of giant mediastinal liposarcoma: A case report

Liposarcoma is the most common soft tissue tumor in adults. Liposarcoma commonly occurs in the lower extremities and retroperitoneum but rarely in the mediastinum. To the best of our knowledge, this is the first report of bilateral single-port video-assisted thoracoscopic surgery (VATS) for giant mediastinal liposarcoma and the first report of esophageal fistula after this surgery.

We present the case of a 71-year-old male patient with a giant posterior mediastinal tumor. Chest computed tomography and magnetic resonance imaging showed that the tumor completely involved the esophagus. The patient underwent bilateral single-port VATS and the tumor was completely removed. An esophageal fistula was detected 9 days after surgery and 2 days after eating. Emergency debridement surgery was performed, and a drainage tube was placed. The fistula healed gradually after the second surgery.

VATS is safer than thoracotomy for treating giant mediastinal liposarcoma. For tumors extensively involving the esophagus, preventive measures against esophageal fistula are necessary.