Median sternotomy is a viable surgical approach for giant mediastinal liposarcomas, though clinicians should be vigilant for postoperative reexpansion pulmonary edema.
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.
Zhang et al. (Thu,) studied this question.