Search

Liposarcoma is a type of common tumor in soft tissue, but liposarcoma originating in the mediastinum is rare. Here, we report a case of the anterior mediastinal liposarcoma resected by a median sternal incision and complicated with reexpansion pulmonary edema after surgery. A 68-year-old female patient with chest tightness and shortness of breath for more than 2 years, recently presents with increased chest tightness and shortness of breath, as well as right upper extremity and lower back pain. Enhanced chest CT scan showed an uneven and low-density mass in the anterior mediastinum with clear border. Most of the mass showed fat density, the anterior part of the mass was solid, and the liquid density was seen in the pericardial cavity. Surgery was performed with a median sternal incision, and part of the pericardium and the innominate vein wall were removed during the removal of the entire liposarcoma. The size of the tumor was about 20 cm × 10 cm × 8 cm. The patient developed a reexpansion pulmonary edema after the giant mediastinal liposarcoma resection, but she was discharged successfully on the 10th postoperative day with the treatment by anti-glucocorticoids and diuretics. Postoperative pathology showed well-differentiated liposarcoma. Now within the half-year follow-up, the patient remained well and there is no sign of recurrence. Median sternotomy is considered to be a good surgical procedure for giant mediastinal liposarcomas. Attention should be given to prevent reexpansion pulmonary edema after surgery.

BACKGROUND: Rate of second primary malignancies (SPM) is steadily increasing over the last decades. New therapies, early diagnostic markers, screening tests for a larger number of individuals contribute to the increase prevalence of SPM. In the current study, we try to described the demographic composition of SPM victims, distribution of primary sites, and the impact of related factors on prognosis. METHODS: We conducted a retrospective study identifying patients over the age of 18 who were diagnosed with SPM from the 16 most common cancer sites between 2000 and 2013 from Surveillance, Epidemiology, and End Results data. Cox proportional hazards regression was used to analyze the relationship between different factors associated to the prognosis of SPM. Standard incidence rate of multiple primary (MP-SIR) was also calculated. RESULTS: A total of 303,753 patients were diagnosis with SPM and 76,168 of whom (25.08%) were included in our analytic cohort. Patients with prostate cancer was vulnerable to SPM, accounting for 34.59%, and SPM was prone to occur in lung and bronchus, accounting for 24.90%. The heat map shows that esophagus cancer survivors have the highest risk of developing stomachache tumors (SIR =5.08). The result of Cox regression suggests that a history of liver was associated with the shortest survival time (HR =1.64, 95% CI, 1.54–1.75, P

Type AB thymoma associated with multiple metastases is rarely encountered. This paper describes the therapeutic effect of new radiotherapy, helical tomotherapy (TOMO), in a thymoma patient with multiple metastases. A male patient aged 52 was diagnosed as type AB thymoma with multiple metastases. Two-cycle chemotherapy was administered as the primary therapy. The efficacy evaluation indicated progressive disease (PD), so radiotherapy was added to the initial treatment. The re-evaluation of efficacy indicated PD under chemotherapy and partial response (PR) in the radiotherapy area, so the latter treatment was changed to TOMO. The TOMO treatment was effective. However, due to the severe bone marrow suppression, the radiotherapy was stopped, and the patient was discharged. We concluded that the development of type AB thymoma associated with multiple metastases was fast, and the patient was sensitive to radiotherapy but not chemotherapy. Thus, TOMO can be selected as the primary palliative therapeutic regimen for chemotherapy-resistant thymoma patients, but the patient tolerance of TOMO requires careful evaluation and further clinical study.