Ye Yi-Wang, Liao Meng-Ying, Mou Zhi-Min, Shi Xiao-Xin, Xie Yuan-Cai
Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
Department of Pathology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
World J Clin Cases. 2020 May 6;8(9):1698-1704. doi: 10.12998/wjcc.v8.i9.1698.
Esophageal liposarcoma is a rare malignant tumor and an esophageal dedifferentiated liposarcoma (DDL) is extremely rare. There are no reports on the treatment of DDL by thoracoscopic surgery.
A 38-year-old woman presented with dysphagia and dyspnea. Imaging examination showed a large mass in the posterior mediastinum. The patient also developed respiratory failure and it was unclear whether this was caused by a mass from inside or outside the esophagus. We decided to perform thoracoscopic exploration to relieve the obstruction caused by tracheal compression. The upper segment of the esophagus was split longitudinally, and most of the mass could be removed from the esophageal lumen to the thoracic cavity. The pedicle was excised by linear cutting closers under mirrors. Little residual mass was visualized by gastroscopy. The mucous and muscular layers were closed by interrupted sutures. Pathological examination showed that the mass was a DDL. The patient did not have any dysphagia or dyspnea 2 wk postoperatively and refused any further treatment. Computed tomography and esophagoscopy did not find any recurrence at up to 20 mo postoperatively.
Thoracoscopy can be used to treat large esophageal masses.
食管脂肪肉瘤是一种罕见的恶性肿瘤,而食管去分化脂肪肉瘤(DDL)极为罕见。目前尚无关于胸腔镜手术治疗DDL的报道。
一名38岁女性出现吞咽困难和呼吸困难。影像学检查显示后纵隔有一个巨大肿块。患者还出现了呼吸衰竭,尚不清楚这是由食管内还是食管外的肿块引起的。我们决定进行胸腔镜探查以解除气管受压所致的梗阻。将食管上段纵向劈开,大部分肿块可从食管腔取出至胸腔。在胸腔镜下用线性切割闭合器切除蒂部。胃镜检查显示残留肿块很少。用间断缝合关闭黏膜层和肌层。病理检查显示肿块为DDL。患者术后2周无任何吞咽困难或呼吸困难,拒绝进一步治疗。术后长达20个月的计算机断层扫描和食管镜检查未发现任何复发。
胸腔镜可用于治疗巨大食管肿块。