Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2020; 8(9): 1698-1704
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1698
Thoracoscopic resection of a huge esophageal dedifferentiated liposarcoma: A case report
Yi-Wang Ye, Meng-Ying Liao, Zhi-Min Mou, Xiao-Xin Shi, Yuan-Cai Xie
Yi-Wang Ye, Zhi-Min Mou, Yuan-Cai Xie, Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Meng-Ying Liao, Xiao-Xin Shi, Department of Pathology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Author contributions: Xie YC designed the research; Mou ZM performed the research; Liao MY and Shi XX, contributed to pathologic diagnosis; Ye YW wrote the paper.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yuan-Cai Xie, MD, Doctor, Surgeon, Department of Thoracic Surgery, Peking University Shenzhen Hospital, Lianhua Road No. 1120, Shenzhen 518036, Guangdong Province, China. xieyuancai2005@126.com
Received: January 26, 2020
Peer-review started: January 26, 2020
First decision: March 15, 2020
Revised: April 9, 2020
Accepted: April 17, 2020
Article in press: April 17, 2020
Published online: May 6, 2020
Processing time: 94 Days and 20.3 Hours
Abstract
BACKGROUND

Esophageal liposarcoma is a rare malignant tumor and an esophageal dedifferentiated liposarcoma (DDL) is extremely rare. There are no reports on the treatment of DDL by thoracoscopic surgery.

CASE SUMMARY

A 38-year-old woman presented with dysphagia and dyspnea. Imaging examination showed a large mass in the posterior mediastinum. The patient also developed respiratory failure and it was unclear whether this was caused by a mass from inside or outside the esophagus. We decided to perform thoracoscopic exploration to relieve the obstruction caused by tracheal compression. The upper segment of the esophagus was split longitudinally, and most of the mass could be removed from the esophageal lumen to the thoracic cavity. The pedicle was excised by linear cutting closers under mirrors. Little residual mass was visualized by gastroscopy. The mucous and muscular layers were closed by interrupted sutures. Pathological examination showed that the mass was a DDL. The patient did not have any dysphagia or dyspnea 2 wk postoperatively and refused any further treatment. Computed tomography and esophagoscopy did not find any recurrence at up to 20 mo postoperatively.

CONCLUSION

Thoracoscopy can be used to treat large esophageal masses.

Keywords: Thoracoscopic surgery; Esophageal liposarcoma; Dedifferentiated liposarcoma; Huge esophageal tumor; Case report

Core tip: An esophageal dedifferentiated liposarcoma (DDL) is extremely rare. Surgery is the best choice of treatment, including aggressive open transcervical, transthoracic, and transabdominal total or subtotal esophagectomy. DDL is a low-malignancy tumor, and minimally invasive treatment can improve postoperative quality of life. There are no reports of thoracoscopic surgery for the treatment of DDL. Here, we present a case of minimally invasive treatment of a large esophageal DDL by thoracoscopy. There was no sign of recurrence and the patient achieved a high quality of life.