Giant liposarcoma occupying most of the hemi-thorax and resected in the supine position: report of a rare case

Liposarcoma originating in the thoracic cavity is not common. It has been reported that neither chemotherapy nor radiotherapy is effective, and that surgical resection is the only therapeutic option. There have been several cases reported of a large liposarcoma compressing adjacent organs such as the lung and the heart. In such cases, careful management is required to prevent adverse cardiopulmonary events during resection. Here we report a rare case of a 52-year-old male who had a giant liposarcoma occupying the majority of the right thorax. The patient was placed in the supine position, and the tumor was resected through an anterior thoracotomy. Percutaneous cardiopulmonary support (PCPS) was prepared in case of need. However, we succeeded in resecting the huge tumor without use of PCPS. We were unable to completely resect the tumor because it originated from the posterior mediastinum and extended into the left thorax. The resected tumor weighed 3,500 g and was 28 cm in largest diameter. The postoperative course was uneventful, except for hypoxemia lasting a few days caused by re-expansion edema in the lung. The patient was discharged and is alive at five years to date.