tailieunhanh - Báo cáo khoa học: " Surgical management of mediastinal liposarcoma extending from hypopharynx to carina: Case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Surgical management of mediastinal liposarcoma extending from hypopharynx to carina: Case report | Gethin-Jones et al. World Journal of Surgical Oncology 2010 8 13 http content 8 1 13 CASE REPORT WORLD JOURNAL OF SURGICAL ONCOLOGY Open Access Surgical management of mediastinal liposarcoma extending from hypopharynx to carina Case report Thomas L Gethin-Jones Nathaniel R Evans III Christopher R Morse Abstract We describe the complete resection of a giant well-differentiated mediastinal liposarcoma extending retropharynx to envelop the aortic arch trachea and esophagus following preoperative radiotherapy. Background Liposarcomas represent only 1 of all malignancies and are commonly found in the lower limbs and retroperito-neum 1 . Rarely are liposarcomas found in the mediastinum and of all primary mediastinal sarcomas only 9 are liposarcomas 2 . Several reports suggest radiation and chemotherapy without surgical resection are ineffective treatments for mediastinal liposarcoma despite often daunting preoperative imaging 1 3 . In this case we report on the surgical resection of a large primary mediastinal liposarcoma by sternotomy. Case presentation A 70-year-old male with no history of radiotherapy presented with gradual swelling of the neck and dyspnea of 7 to 8 months duration. Magnetic resonance imaging MRI and computed tomography CT scans of the neck and chest revealed a large mass extending from the hypopharynx to the carina Figures 1 2 causing significant displacement of the larynx trachea and esophagus as well as encasing the aortic arch. Fine needle aspiration FNA biopsy returned well-differentiated liposarcoma. Improvement of symptoms came with 10 cycles of neoadjuvant radiotherapy prior to surgical resection. The patient was intubated while spontaneously ventilating and with rigid bronchoscopy available. Initial bronchoscopy revealed compression of the right main-stem bronchus. Passage of an upper gastrointestinal Correspondence crmorse@ Division of Thoracic Surgery Massachusetts General Hospital Blake 1570 55 Fruit St Boston MA .