Yang Yanhui, Li Ji, Cheng Sipeng, Mei Jinyuan, Cheng Xin, Jing Min, Wang Yi
Department of Cardiothoracic Surgery, The First People's Hospital of Neijiang, No. 1866, West Section of Hanan Avenue, Shizhong District, Neijiang, Sichuan, 641000, P.R. China.
School of Clinical Medicine, Southwest Medical University, Luzhou City, Sichuan, 646000, P.R. China.
J Cardiothorac Surg. 2025 Jan 6;20(1):21. doi: 10.1186/s13019-024-03245-1.
Primary mediastinal liposarcomas (PLMs) are extremely rare. Patients typically present with symptoms caused by tumor size, as the mass can compress surrounding tissues and organs. Here, we report a case of a large primary mediastinal liposarcoma that was successfully resected thoracoscopically. By reviewing the available literature on mediastinal liposarcomas and sharing perioperative insights, we aim to provide guidance on the diagnosis and surgical management of large mediastinal liposarcomas.
A 38-year-old male presented to our hospital with complaints of dysphagia after meals. Chest computed tomography (CT) revealed a large space-occupying lesion in the posterior upper mediastinum, and gastroscopy identified esophageal compression without evidence of new growth. The patient underwent thoracoscopic resection, resulting in significant improvement of his dysphagia postoperatively. He experienced no postoperative complications and was discharged one week following surgery.
The incidence of PLM is very low. Due to the proximity of vital structures such as the vena cava, esophagus, trachea, and subclavian artery, surgical resection presents elevated risks and complexity. While minimally invasive thoracoscopic techniques offer both safety and efficacy, careful preservation of surrounding organs is essential during the procedure.
原发性纵隔脂肪肉瘤（PLM）极为罕见。患者通常因肿瘤大小引发症状，因为肿块会压迫周围组织和器官。在此，我们报告一例经胸腔镜成功切除的巨大原发性纵隔脂肪肉瘤病例。通过回顾关于纵隔脂肪肉瘤的现有文献并分享围手术期见解，我们旨在为巨大纵隔脂肪肉瘤的诊断和手术管理提供指导。
一名38岁男性因餐后吞咽困难前来我院就诊。胸部计算机断层扫描（CT）显示后上纵隔有一个巨大占位性病变，胃镜检查发现食管受压但无新生物迹象。该患者接受了胸腔镜切除术，术后吞咽困难明显改善。他术后未出现并发症，术后一周出院。
PLM的发病率很低。由于诸如腔静脉、食管、气管和锁骨下动脉等重要结构位置临近，手术切除存在较高风险且操作复杂。虽然微创胸腔镜技术兼具安全性和有效性，但术中仔细保护周围器官至关重要。
