Successful removal of giant mediastinal lipoma and liposarcoma involving both chest cavities

Abstract

Rationale:Surgical removal of a giant mediastinal lipoma or liposarcoma involving both chest cavities is always challenging.Patient concerns:We present 2 cases of giant mediastinal tumor, one of which was a 22-year-old female who was admitted to our hospital due to a mild dyspnea after running. Computed tomography (CT) scan revealed a large mass with low density occupying the entire right hemithorax and extending anteriorly into the left. The other patient was a 43-year-old male, who was presented to the hospital with complaints of gradually progressive dyspnea. CT scan revealed a mass comprised of fat density with areas of soft-tissue density in-between, involving in both chest cavities, draping around the heart and great vessels.Interventions:Both of the patients receive complete resection through a standard median sternotomy.Diagnoses:Histologic examination revealed lipoma for the first patient, and well differentiated liposarcoma for the second.Outcomes:Both of their symptoms were improved after surgery and the postoperative courses were good.Lessons:Our experience indicated that complete surgical removal through a standard median sternotomy is a safe and efficient approach for the treatment of giant mediastinal lipoma and liposarcoma.

Successful removal of the largest reported intrathoracic lipoma with bilateral extension: a case report

“…In our case, the patient’s shortness of breath was due to the compressed lung by the massive size of the lipoma, resulting from reduced lung volume. We did not find any intrathoracic lipoma in the literature more than 3500 gm and as large as the reported case by us [ 1 , 13 ].…”

“…Clamshell thoracotomy has also been employed to remove the bilateral intrathoracic lipoma [ 17 ]. Whereas, median sternotomy allows complete assessment of both chest cavities and the mediastinum, which ensures en-bloc removal of the encapsulated tumor [ 13 ]. In our experience, lateral thoracotomy may affect the exposure in case of a large tumor, resulting in rupture of the capsule [ 2 ].…”

Resection of a huge mediastinal well-differentiated liposarcoma involving left thoracic cavity

“…Neither lipoma nor liposarcoma is sensitive to chemotherapy or radiotherapy, and complete surgical resection is the first-line treatment choice [5]. When the tumor is enormous and solid, it is inadequate to use the thoracoscopic approach since complete tumor resection maybe difficult using this approach.…”

Benign but Terminal: Cardiopulmonary Collapse from a Massive Chest Wall Lipoma

“…However, locations such as the chest wall or intramediastinal can predispose to symptoms owing to the compression of underlying tissues with progressive growth. 3 We report a case of complete unilateral lung collapse secondary to a large right-sided chest wall mass found to be a lipoma, mandating care in the intensive care unit for persistent hypercapneic and hypoxic respiratory failure. Due to its inoperability, the mass progressed, causing end-stage restrictive lung disease and ultimately contributed to patient demise.…”