Giant esophageal liposarcoma with squamous cell carcinoma resected via the cervical approach: a case report

Abstract

Background Liposarcoma is one of the most common soft tissue sarcomas, but is extremely rarely found in the esophagus. There have been no reports of esophageal liposarcoma together with superficial carcinoma of the esophagus. Here, we report a patient who underwent complete resection of esophageal liposarcoma with carcinoma via a cervical approach. Case presentation A 66-year-old man was diagnosed with an esophageal tumor 11 years ago, but he left it untreated. He presented to our hospital with progressive dysphagia and appetite loss since the previous year. Esophagogastroduodenoscopy (EGD) showed a large pedunculated submucosal tumor (SMT) originating at the esophageal entrance, extending to the gastroesophageal junction. Additionally, there was a superficial carcinoma on the surface of the SMT, 30 cm from the incisor teeth. Three-dimensional computed tomography (3D-CT) showed a giant elongated intraluminal tumor extending downwards from the cervical esophagus. We diagnosed a giant esophageal polyp accompanied by a superficial carcinoma and performed tumor resection via a cervical approach. The excised specimen consisted of a 23.0 × 8.5 cm polypoid mass. The final diagnosis by histopathological and immunohistochemical examination was well-differentiated liposarcoma and esophageal squamous cell carcinoma. He was discharged on postoperative day 14 with drastic improvement in his swallowing ability. Conclusion We reported an extremely rare case of esophageal liposarcoma together with esophageal squamous cell carcinoma that was successfully resected through a small cervical incision.

Recurrent giant esophageal liposarcoma that was successfully treated by surgery: A case report

“… 4 However, findings from Ortega and colleagues 5 raise concerns, as their study revealed that enucleation of liposarcomas located in the posterior mediastinum resulted in positive surgical margins in a noteworthy 63.6% of cases (7 of 11). Taking into account the favorable prognosis associated with the well-differentiated recurrent tumor and the feasibility of achieving en-bloc dissection, E1 our multidisciplinary team opted for an esophagectomy, employing a 3-incision technique. This approach was chosen to mitigate the risk of tumor recurrence to the maximum possible extent.…”

Esophageal Liposarcoma: A Case Report and Review of the Literature

“…They are exceedingly rarely found in the gastrointestinal (GI) tract, and even more so in the esophagus where they comprise 1.2%-1.5% of all GI liposarcomas [2]. They are derived from primitive mesenchymal cells and usually arise from the esophageal submucosa [3]. Since the publication of the first case report in 1983, 76 cases of esophageal liposarcoma have been reported in the English-language medical literature [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

“…They are derived from primitive mesenchymal cells and usually arise from the esophageal submucosa [3]. Since the publication of the first case report in 1983, 76 cases of esophageal liposarcoma have been reported in the English-language medical literature [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The clinical presentation of these tumors is usually with symptoms of dysphagia, dyspnea, or, in some cases, regurgitation of the mass [2].…”

“…The clinical presentation of these tumors is usually with symptoms of dysphagia, dyspnea, or, in some cases, regurgitation of the mass [2]. Evaluation often reveals a pedunculated intraluminal mass, which may be visible on contrast esophagography [3,4]. Esophageal liposarcomas are associated with a better prognosis than their conventional counterparts at other sites and usually do not metastasize from their primary location [5].…”

“…Biopsy and immunohistochemistry for MDM2 gene locus amplification remain critical for diagnosis [7]. The primary treatment for esophageal liposarcoma is surgical; the choice of open esophagotomy versus endoscopic approach depends upon individual tumor characteristics [3]. Local recurrence has been described in up to 10% of cases, emphasizing the importance of complete resection with negative margins and longterm follow-up [8].…”