Anterior mediastinal leiomyosarcoma mimicking thymoma

Abstract

Rationale:Mediastinal leiomyosarcoma is very rare. In this paper, we report one case of anterior mediastinal leiomyosarcoma and retrospectively review the imaging findings of previously reported cases.Patient Concerns:A 61-year-old male patient was admitted to our hospital due to the presence of a mediastinal space-occupying lesion for two years. Two years previously, chest computed tomography (CT) showed a small nodule in the anterior mediastinum. Twenty days previously, the CT examination was repeated at the local hospital due to respiratory symptoms, which showed a mass in the anterior mediastinum and interstitial inflammation of both lungs. After admission to our hospital, chest contrast-enhanced CT scanning showed a mass in the right anterior mediastinum that was approximately 3.3 × 5.2 cm2 in size that had a clear boundary, slightly heterogeneous internal density and heterogeneous enhancement.Interventions:The patient underwent a mediastinal lump resection.Diagnoses:Finally, the pathological diagnosis was anterior mediastinal leiomyosarcoma.Outcomes:The patient recovered well after the operation.Lessons:Accidental discovery of anterior mediastinal nodules should be followed up. Mediastinal leiomyosarcoma is common in the posterior mediastinum. Imaging shows a heterogeneous mass with a space-occupying effect that may easily involve adjacent mediastinal vessels or infiltrate surrounding organs.

Anterior Mediastinal Leiomyosarcoma: A Case Report and Literature Review

“…Primary mediastinal sarcomas are mostly derived from mediastinal organs, such as the heart, esophagus, and the blood vessels. Only 7 cases of anterior mediastinal leiomyosarcomas have been reported [7-10]. Here, we report an extremely rare case of anterior mediastinal leiomyosarcoma in an 85-year-old female.…”

“…Mediastinal leiomyosarcoma is a very rare tumor with less than 50 cases reported as case reports and a few small case series [7-13]. This tumor occurs typically in the posterior mediastinum [9].…”

“…This tumor occurs typically in the posterior mediastinum [9]. Cases in the anterior mediastinum are extremely rare [7-10, 12]. The clinicopathological features of the 7 previously reported cases are summarized in Table 1.…”

Diagnostic value of contrast-enhanced ultrasonography in mediastinal leiomyosarcoma mimicking aortic hematoma: A case report and review of literature

“…It has been reported that foreign bodies such as bullets, laparotomy sponges, and bone wax may be associated with sarcoma causes, but the exact mechanisms are unclear[ 18 , 19 ]. Initial primary mediastinal leiomyosarcoma symptoms lack specificity and depend on the tumor location[ 1 , 2 , 10 , 20 , 21 ]. Posterior mediastinal tumors often do not cause obvious clinical symptoms and discomfort in the early stage[ 9 ].…”

A case of leiomyosarcoma originating from a bronchogenic cyst: A case report

“…A leiomyosarcoma is an aggressive malignant tumor that originates in the mesenchymal tissue (2). Mediastinal leiomyosarcomas mostly occur in mediastinal organs, such as the heart, great vessels, and esophagus, usually manifesting as posterior mediastinal tumors, and rarely as anterior mediastinal tumors (3). Only few cases of anterior mediastinal leiomyosarcomas have been reported to date (3).…”