Successful Resection of a Recurrent Mediastinal Liposarcoma Invading the Pericardium: Report of a Case

Primary liposarcoma of the mediastinum is rare, but cases of recurrence have been reported in the English literature. We successfully resected a recurrent pericardial liposarcoma, detected 5 years after the initial resection of a liposarcoma of the anterior mediastinum invading the pericardium. Routine follow-up computed tomography showed the recurrence and suggested invasion of the pericardial cavity, which was supported by the findings of transesophageal ultrasonography. As cine-magnetic resonance imaging suggested that the tumor was resectable, an operation was performed. Histopathology confirmed the diagnosis of recurrent liposarcoma and showed clear surgical margins.     

Amyloid Tumor in the Anterior Mediastinum: Report of a Case

A 33-year-old woman being treated for rheumatoid arthritis was referred to our hospital for investigation of a mediastinal mass. A chest computed tomography scan showed an anterior mediastinal mass, 8.5 × 7.0cm in size, with a cystic lesion and calcification. These findings were suggestive of either a noninvasive thymoma or a mature teratoma. Therefore, we performed tumor resection and thymectomy. Histologically, the tumor consisted of diffuse deposits of massive eosinophilic amorphous material. The tumor was stained red-orange by Congo red, and the staining disappeared following potassium permanganate digestion. Based on these findings, a diagnosis of reactive amyloidosis of the amyloid A-protein-derived type was made. Amyloidosis in the mediastinum has rarely been described.     

Primary Cardiac Liposarcoma Causing Cardiac Tamponade: Report of a Case

The intracardiac growth and extension of liposarcoma was observed in a 60-year-old woman. The epicardial tumor was identified to originate from the anterior wall of the right ventricle. She initially showed symptoms associated with cardiac tamponade. A surgical operation was performed but it resulted in incomplete resection due to massive invasion and dissemination. The recurrence of the tumors led to congestive heart failure. Finally, she died of heart failure and liver dysfunction as a result of tumor metastasis and invasion. An autopsy detected the primary cardiac liposarcoma. Only a few cases of cardiogenic liposarcoma have so far been reported. A further elucidation of cardiac liposarcoma could reveal mechanisms of the disease, and thus contribute to development of complementary therapies after surgical intervention.     

Laparoscopic Resection of a Retroperitoneal Liposarcoma: A Case Report and Review of the Literature

Here, we describe a case of a retroperitoneal liposarcoma successfully managed by laparoscopic surgery. A 72-year-old man underwent abnormal hypertension screening using computed tomography (CT), which revealed a low-density mass measuring 7 cm in diameter in the retroperitoneal space. We diagnosed the mass as a liposarcoma before the operation. The mass was resected laparoscopically. No perioperative complications were encountered, and the patient was discharged on the fourth postoperative day. The pathologic diagnosis was well-differentiated liposarcoma, indicating complete surgical resection. Thus, we conclude that a laparoscopic approach for the patients with retroperitoneal tumors, including liposarcomas, is safe, feasible, and minimally invasive, even if there is a possibility of the tumor being malignant.     

Synovial Sarcoma of the Mediastinum: Report of a Case

We report a case of synovial sarcoma of the mediastinum, a very rare tumor, in a 50-year-old man hos-pitalized with anterior chest pain. Chest X-ray and computed tomography (CT) on admission showed a 10 × 8-cm mass in the right anterior mediastinal space, compressing the superior vena cava. A diagnosis of sarcoma was established by a CT-guided percutaneous needle biopsy. Systemic examination revealed no metastasis to the contralateral pleural cavity or other distant organs, and we resected the mediastinal sarcoma. Pathological and immunohistochemical analyses confirmed a diagnosis of monophasic synovial sarcoma. The patient is alive with recurrence 9 months after his operation, and is receiving chemotherapy with ifosfamide.     

Multicystic Mesothelial Cyst of the Mediastinum: Report of a Case

We report the rare case of a multicystic mesothelial cyst of the mediastinum. A 43-year-old man was referred to our department after a routine chest X-ray showed an anterior mediastinum mass. The lesion was resected by thoracoscopy, which revealed multicystic, thin-walled tense masses arising in the anterior mediastinum. The cysts were not adherent to the pericardium or to the thymus of the right lobe. Immunohistochemistry revealed that the cyst was lined with a layer of mesothelial cells and there were no malignant foci. The lining cells were positive for keratin and negative for the lymphocyte marker. These findings were consistent with a diagnosis of multicystic mesothelial cyst. Received: March 19, 2002 / Accepted: July 2, 2002 Acknowledgment. We would like to thank Ms. Miyazaki for her excellent technical assistance in pathology. Reprint requests to: H. Sasaki     

Pancreas-Sparing Duodenectomy for a Recurrent Retroperitoneal Liposarcoma: Report of a Case

Pancreas-sparing duodenectomy (PSD), which allows preservation of the pancreas in its entirety, is a promising procedure for low-grade malignancies of the duodenum, the periampullary region, and the neighboring retroperitoneum. We report a case of recurrent retroperitoneal liposarcoma involving the second and third parts of the duodenum, which was extirpated using PSD, after a right hemicolectomy for tumor invasion of part of the colonic hepatic flexura. The Roux-en-Y jejunal limb was sutured to the duodenal bulb in an end-to-end fashion, and the biliary and pancreatic duct systems were reconstructed with end-to-side anastomoses, placing the jejunal limb distal to the bulbo-jejunostomy after a septoplasty to repair the adjacent pancreatic and biliary ducts. Because retroperitoneal liposarcoma has a low incidence of lymph node metastasis, pancreaticoduodenectomy may be inappropriate, especially if minimally extensive surgery can ensure organ preservation. Pancreas-sparing duodenectomy could be the most appropriate procedure for nonepithelial malignant tumors located around the duodenum distal to the pylorus, which have no involvement with the pancreatic parenchyma or periduodenal lymph nodes.     

Neurilemoma Originating from the Left Recurrent Nerve in the Superior Mediastinum: Report of a Case

We report a rare case of neurilemoma originating from the left recurrent nerve in the superior mediastinum.     

Thoracoscopic Resection of Middle Mediastinal Noninvasive Thymoma: Report of a Case

We performed thoracoscopic resection of a middle mediastinal noninvasive thymoma in a 69-year-old woman. Chest computed tomography on admission showed a tumor, 75 x 48 x 32 mm in size, and pathological examination revealed a spindle-cell, noninvasive thymoma, of type A according to the World Health Organization classification, and stage I according to the Masaoka staging system. Thymomas are prone to ectopic occurrence, and should be considered in the differential diagnosis of middle mediastinum tumors.     

Liposarcoma of the Spermatic Cord: Report of 2 Cases

These case reports describe the rare condition of liposarcoma of the funiculus spermaticus.

It is treated by radical surgical resection. The diagnosis is usually made postoperatively. The role of adjuvant radio-or

chemotherapy is uncertain.     

Strangulated Umbilical Hernia in a Child: Report of a Case

Most umbilical hernias in children close spontaneously. Complications associated with umbilical hernias are rarely observed during follow-up. We report herein a 5-month-old girl with a strangulated umbilical hernia. Her umbilicus was hard, reddish, and irreducible. Plain radiography of the abdomen showed signs of mechanical ileus. The patient was thus diagnosed to have a strangulated umbilical hernia. A 5-cm section of the ascending colon and a 5-cm section of the terminal ileum, as well as the cecum and appendix, were congested, edematous, and erythematous, and together were enclosed by a firm hernial ring. A closure of the fascial defect and umbilicoplasty were performed. The postoperative course was uneventful. In patients with infantile umbilical hernias, strangulation may occur as the fascial defect decreases in size. Received: May 30, 2000 / Accepted: January 9, 2001     

Aneurysmal Bone Cyst of the Rib in a Child: Report of a Case

An aneurysmal bone cyst (ABC) is a benign tumor of the skeletal system, which is rare in childhood and mostly occurs in long bones. An aneurysmal bone cyst of the rib is also very rare and it is difficult to distinguish from other rib tumors of childhood, especially Ewing’s sarcoma. An unusual case of an aneurysmal bone cyst in the rib of a 12-year-old boy is presented herein. The entity is discussed with special emphasis on the clinicopathologic features, differential diagnosis, and treatment. The most important diagnostic aid in accurately identifying such cysts is to be aware of such a possible diagnosis when a child presents with a rib mass. An en bloc resection of the mass along with the affected portion of the rib is mandatory to obtain a satisfactory outcome.     

Liposarcoma scroti: a rare paratesticular tumor

Paratesticular liposarcoma is a rare condition characterized by a growing, painless inguinal, or scrotal mass. To our knowledge, less than 200 cases worldwide are reported thus far. It is characterized by slow growth and can reach large dimensions at diagnosis. Paratesticular well-differentiated liposarcoma has a prolonged clinical course with recurrences in more than half the cases, sometimes late. Regardless of tumor size, radical orchidectomy with free surgical margins is recommended in order to avoid recurrence. When there is tumor recurrence, reoperation is the treatment of choice because radio- and chemotherapy have yet to be well established in these cases. There is a low risk of metastasis. Overall prognosis is good. Adjuvant therapies, represented by radio- and chemotherapy, have a controversial role in the literature due to the rarity of the disease. In this article, we present review of the literature and case discussion of paratesticular liposarcoma with focus on diagnosis, treatment and follow-up.     

Liposarcoma of the spermatic cord: a report of two cases

Liposarcomas of the spermatic cord are unusual and rarely reported in the literature. These tumours can sometimes be mistaken for the common scrotal swellings such as hydrocoeles and hernias. Careful clinical and radiological examination will help in appropriate preoperative planning and surgery by an experienced surgical team. We report our experience of two cases of such scrotal swellings.     

Liposarcoma of the spermatic cord

Primary malignant tumors of the spermatic cord are rare. We report a caseof paratesticular liposarcoma and discuss the prognosis of this neoplasmand its therapeutic implications.     

Benign Mature Cystic Teratoma of the Anterior Mediastinum Leading to Heart Failure: Report of a Case

A 12-year-old male child was referred to our clinic for the surgical treatment of an anterior mediastinal mass, suspected to be a thymic cyst, which was considered to potentially lead to cardiac failure. The mass was resected completely with a median sternotomy. The postoperative course was uneventful. A pathological examination revealed a mature cystic teratoma of anterior mediastinum which is a very rare cystic tumor at this location. The incidence, diagnostic procedures, complications, and treatment of mediastinal teratomas are discussed along with a review of the literature.     

Suppurated Mediastinal and Cardiac Echinococcosis: Report of a Case

We herein report the case of a suppurated mediastinal and cardiac hydatid cyst which occurred after the initial treatment of the patient for a primary mediastinal hydatid cyst in a radiology department. Both extracorporeal circulation and total circulatory arrest were used during the operation. We believe that surgery is the only feasible treatment for hydatid cysts located in the mediastinum, and surgery should be urgently performed whenever a possible rupture is suspected in order to avoid a possible anaphylactic reaction, mediastinal suppurations leading to serious complications, and growth into the pleural cavity.     

Giant Mesenteric Lipoma as a Rare Cause of Ileus in a Child: Report of a Case

Mesenteric lipoma is a rare benign tumor of mature fat cells. Although generally asymptomatic, it occasionally causes abdominal pain, ileus, and small bowel volvulus, depending on its location and size. A definitive diagnosis can be made by pathological examination. Ultrasonography and abdominal computed tomography show this lesion as a well-defined, homogeneous mass with fat density surrounded by a thin capsule. Because of its rare etiologic origin, we report the case of a 7-year-old girl with a mass in the abdomen and ileus, found to be caused by a mesenteric lipoma.     

Dedifferentiated Liposarcoma of the Pleura: Report of a Case

We report a case of dedifferentiated liposarcoma of the pleura in a 59-year-old man who presented with pain in the right chest wall, 3 years after a routine chest X-ray showed a large tumorous mass. The resected tumor was composed of three distinct histological features: well-differentiated liposarcoma with low-grade leiom-yosarcomatous and low-grade osteosarcomatous components. To our knowledge, this is the first report of dedifferentiated liposarcoma of the pleura.