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Review
. 2022 Dec 10;11(24):7353.
doi: 10.3390/jcm11247353.

Clinicopathological Features of Intrathoracic Liposarcoma-A Systematic Review with an Illustrative Case

Kajetan Kiełbowski  1 , Nikola Ruszel  2 , Seweryn Adam Skrzyniarz  3 , Małgorzata Edyta Wojtyś  1 , Rafał Becht  4 , Konrad Ptaszyński  5 , Darko Gajić  1 , Janusz Wójcik  1
Affiliations
Review

Clinicopathological Features of Intrathoracic Liposarcoma-A Systematic Review with an Illustrative Case

Kajetan Kiełbowski et al. J Clin Med. .

Abstract

Background: Liposarcoma (LPS) is one of the most common soft-tissue sarcomas. However, intrathoracic LPS is rare, as only 1% of all LPS cases are found in the thorax.

Methods: A systematic literature review through PubMed and Embase databases was performed. Only eligible case reports and case series reporting intrathoracic LPS in adult patients were included. Kaplan-Meier curves were calculated to evaluate the survival rate of included patients based on the histological subtype of LPS.

Results: 123 studies reporting 197 patients were included. We added a case of a 69-year-old female patient with recurrent giant intrathoracic LPS. The primary tumor measured 15.1cm × 22.9 cm × 21.9 cm and weighed 3100 g. Six months later, the patient was admitted to the hospital with another intrathoracic tumor measuring 9.5 cm × 9 cm× 1.4 cm. The immunohistochemical studies showed expression of murine double minute 2 (MDM2) antigen in both primary and recurrent tumor cells.

Conclusions: Dyspnea, chest pain, and cough were the most common symptoms reported in included studies. Overall, the 5-year survival rate was 62%. The highest survival was observed in well-differentiated LPS patients (80%) and the lowest in myxoid LPS (31%).

Keywords: intrathoracic liposarcoma; liposarcoma; thoracic surgery; well-differentiated liposarcoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Radiological imaging of the patient during the first surgery. (A): CT with a massive lesion in the right thoracic cavity, 15.1 cm × 22.9 cm × 21.9 cm in size. (B,C): Pre- and postoperative chest X-rays of the patient.
Figure 2
Figure 2
Intraoperative picture of the giant intrathoracic liposarcoma.
Figure 3
Figure 3
Atypical Lipomatous Tumor (ALT)/Well-Differentiated Liposarcoma (WDL). Lipoma-like histological appearance, with most of the tumor showing mature adipose tissue histology. Only rare, scattered spindle stromal cells with hyperchromatic nuclei were observed. (H&E; 400×).
Figure 4
Figure 4
Radiological imaging of the patient during the second surgery. (A–D): CT images from August 2022 with a massive lesion in the posterior mediastinum. (E,F): Pre- and postoperative chest X-rays of the patient from 21 September 2022 and 29 September 2022, respectively.
Figure 5
Figure 5
Flow diagram of the selection process.
Figure 6
Figure 6
Kaplan–Meier survival curves based on histological subtypes: (A): all subtypes; (B): Well-differentiated liposarcoma; (C): Dedifferentiated liposarcoma; (D): Myxoid liposarcoma; (E): Pleomorphic liposarcoma.
See this image and copyright information in PMC

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