Introduction: Liposarcoma is a malignant tumor of immature fat cells or lipoblasts most commonly occurring in the extremities or retroperitoneum, but rarely found on or within visceral organs. Case Report: We report a case of a symptomatic gastric liposarcoma successfully diagnosed pre-operatively by imaging and immunohistochemistry ultimately treated with a partial gastrectomy. Conclusion: This case highlights reviews the importance of preoperative tissue diagnosis, adequate resection, and a multi-disciplinary approach towards infrequently encountered tumors. Based on this experience and a review of available case reports and series, we offer safe and reasonable recommendations for the work-up and treatment of gastric liposarcomas.
Background
Having a broad differential and knowing how to manage the different possibilities in a patient with chest pain is important. Esophageal bezoars are rare entities and are even less common in patients without any recent hospitalizations, known achalasia, or nasogastric tubes. Despite their rarity, having it in one’s differential, and knowing how to manage it is important.
Case presentation
This case presents a patient with mega-esophagus secondary to an esophageal bezoar; and runs through the gamut of morbid chest pathophysiology, its differential, work-up, and management. The case is interesting in that the patient’s initial presentation brings to mind a bevy of feared chest issues to include myocardial infarction, dissection, pulmonary embolus, achalasia, and perforation.
Conclusion
This clinical case highlights more than just the rare diagnosis of esophageal bezoar. It also goes through initial resuscitation, key concerns, “can’t miss diagnoses”, and finally discusses the feared end state of an esophageal perforation.
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