Giant Dedifferentiated Liposarcoma of the Mediastinum.
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All Authors
Khan, JA.
Aleem, MU.
Alhawiti, T.
Nardini, M.
Broggi, G.
Magro, G.
Migliore, M.
LTHT Author
Nardini, Marco
LTHT Department
Thoracic Surgery
Non Medic
Publication Date
2026
Item Type
Case Reports
Journal Article
Language
Subject
SARCOMA , DISEASE-FREE SURVIVAL , SURGICAL PROCEDURES, OPERATIVE , THORACIC SURGERY , MEDIASTINAL NEOPLASMS
Subject Headings
Abstract
AIM: Soft tissue sarcomas are rare, accounting for only 1% of adult malignancies, with liposarcoma being a common subtype. However, mediastinal liposarcomas are extremely uncommon, comprising less than 1% of cases. Dedifferentiated liposarcoma (DDLPS) is a particularly aggressive variant, characterized by a transition from well-differentiated to high-grade non-lipogenic sarcoma. Due to its rarity and often asymptomatic nature until significant progression, mediastinal DDLPS presents a unique diagnostic and therapeutic challenge.
CASE PRESENTATION: An 83-year-old woman with ischemic heart disease presented with progressive dyspnea over two months. Imaging revealed a giant, well-circumscribed mediastinal mass (21 x 23 x 25 cm), occupying 80% of the thoracic cavity and causing significant pulmonary compression and mediastinal shift. A multidisciplinary tumor board recommended surgical resection.
RESULTS: Initial uniportal video-assisted thoracic surgery exploration confirmed no pleural invasion. This was followed by a posterolateral thoracotomy for complete tumor excision. The patient recovered without complications. Histopathology confirmed DDLPS with complex histological architecture, including both well-differentiated and dedifferentiated sarcomatous components. The patient is disease-free three years postoperatively.
CONCLUSIONS: Our case report emphasizes the requirement of a multidisciplinary approach to treat massive chest malignancy. Complete surgical resection remains the gold standard to obtain long-term survival. ©
Journal
Annali Italiani di Chirurgia