Primary liposarcoma of esophagus: a case report

Abstract

Liposarcoma is the most common soft tissue sarcoma in adult life while esophageal liposarcoma is an extremely rare tumor. In the world literature, only 14 cases of esophageal liposarcomas have been described. We report a 72-year old male patient who was urgently admitted to our hospital for acute epigastric pain with a burning retrosternal sensation, persistent nausea, vomiting and dysphagia. Barium swallow, upper gastrointestinal (GI) endoscopy, esophageal manometry and CT scan, failed to accurately diagnose the lesion. After surgical resection of an esophageal polypoid tumor, the histological examination revealed a well-differentiated grade I liposarcoma. Diagnostic and therapeutic tools were discussed and the results of literature were reviewed.

Figure 1

upper GI endoscopy A big hemorrhagic polypoid lesion as a haematoma in the hiatus hernia at upper GI endoscopy

Figure 2

Intraluminal mass with a lipoma-like density in the lower esophagus.

Figure 3

The lesion is covered by yellowish exudates at the second upper GI endoscopy.

Figure 4

Intraoperative view of the esophageal liposarcoma (A) and the specimen (B) (5 cm x 3.5 cm x 2 cm).

Figure 5

Neoplasm infiltrating smooth muscle layer of esophagus and ulcerating surface epithelium (A),HE 100x; and neoplasm consisting of differently-sized lipocytic element and multi-vacuolated lipoblasts (B), HE 400x. A small amount of sclerotic stroma was focally identified with the presence of atypical stromal cells.

Figure 6

No evidence of tumor recurrence in gastrointestinal endoscopy after 6 mo of surgery.