Skip to main content

Advertisement

SpringerLink
Log in

A Pedunculated Giant Esophageal Liposarcoma: a Case Report and Literature Review

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

The majority of esophageal tumors arise from the mucosal layer; only 5 % are of mesenchymal origins. Of the latter, barely 0.5 % are liposarcomas. We present a case of an esophageal liposarcoma with a review of the literature.

Case Report

A 64-year-old male was referred with 5 years of progressive dysphagia. Preoperative evaluation initially suggested a leiomyoma. The polypoid lesion was then resected through a cervical esophagotomy, once endoscopic resection proved to be not feasible. The definitive pathologic diagnosis confirmed a well-differentiated liposarcoma.

Literature Review

Esophageal liposarcomas are very rare and only 40 such cases have been reported in the literature. Most patients were male (80 %), the median age was 62 years (range 38–83 years), and the most common symptom was dysphagia (85 %). Only in two cases was a liposarcoma detected on preoperative biopsy. The most common histological subtype was well-differentiated liposarcoma. Overall, 77.5 % of the patients were successfully treated with surgery, 20 % endoscopically, and 2.5 % were ablated with CO2 laser.

Conclusion

Esophageal liposarcoma is an extremely rare tumor. The majority of patients are males; dysphagia is the most common initial symptom, and preoperative biopsy is unreliable. Because these tumors are pedunculated, well-circumscribed, and well-differentiated, they can be safely resected locally. All patients need long-term follow-up as this disease can recur many decades after treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Smith, Kluck, Jagannath and Yang, Giant multi-polypoid liposarcoma of the esophagus: an atypical presentation. Ann Thorac Surg, 2010;89(2):610–2.

    Article  PubMed  Google Scholar 

  2. Czekajska-Chehab, Tomaszewska, Drop, Dabrowski, Skomra, Orlowski, Kolodziej and Korobowicz, Liposarcoma of the esophagus: case report and literature review. Med Sci Monit, 2009;15(7): CS123–7.

    PubMed  Google Scholar 

  3. Temes, Quinn, Davis, Endara, Follis, Pett and Wernly, Endoscopic resection of esophageal liposarcoma. J Thorac Cardiovasc Surg, 1998;116(2): 365–7.

    Article  CAS  PubMed  Google Scholar 

  4. Aloraini, Nahal and Ferri, Transoral endoscopic resection of esophageal liposarcoma. Ann Thorac Surg, 2012; 94(5):e121–2.

    Article  PubMed  Google Scholar 

  5. Arteaga-Gonzalez, Fernandez and Higa, A minimal invasive approach of esophageal liposarcoma. J Laparoendosc Adv Surg Tech A, 2008; 18(2):266–70.

    Article  PubMed  Google Scholar 

  6. Baca, Klempa and Weber, Liposarcoma of the esophagus. Eur J Surg Oncol, 1991; 17(3): 313–5.

    CAS  PubMed  Google Scholar 

  7. Bak, Kim, Kim, Lee, Lee, Choi and Kim, Liposarcoma arising in a giant lipomatous polyp of the esophagus. Korean J Intern Med, 1989; 4(1):86–9.

    CAS  PubMed  Google Scholar 

  8. Beaudoin, Journet, Watier, Mongeau, Chagnon and Beaudry, Giant liposarcoma of the esophagus. Can J Gastroenterol, 2002; 16(6):377–9.

    PubMed  Google Scholar 

  9. Boggi, Viacava, Naccarato, Giulianotti, di Candio, Battolla and Mosca, Giant pedunculated liposarcomas of the esophagus: literature review and case report. Hepatogastroenterology, 1997; 44(14):398–407.

    CAS  PubMed  Google Scholar 

  10. Brehant, Pessaux, Hennekinne-Mucci, Barriere, D’Aubigny, Aube, Boyer and Arnaud, Giant pedunculated liposarcoma of the esophagus. J Am Coll Surg, 2004; 198(2):320–1.

    Article  PubMed  Google Scholar 

  11. Chung, Kim, Kim, Lee, Yoo and Kim, Imaging findings of giant liposarcoma of the esophagus. Yonsei Med J, 2003; 44(4):715–8.

    Article  PubMed  Google Scholar 

  12. Cooper, Boucher, Smith and Thorpe, Liposarcoma of the esophagus. Ann Thorac Surg, 1991; 51(6):1012–3.

    Article  CAS  PubMed  Google Scholar 

  13. Di Mascio, Gamble, Wajed and Winslet, Intussuscepting giant liposarcoma of the oesophagus. J Postgrad Med, 2006; 52(3):231–2.

    CAS  PubMed  Google Scholar 

  14. Garcia, Buitrago, Bejarano and Casillas, Large esophageal liposarcoma: a case report and review of the literature. Arch Pathol Lab Med, 2004; 128(8):922–5.

    PubMed  Google Scholar 

  15. Ginai, Halfhide, Dees, Zondervan, Klooswijk and Knegt, Giant esophageal polyp: a clinical and radiological entity with variable histology. Eur Radiol, 1998; 8(2):264–9.

    Article  CAS  PubMed  Google Scholar 

  16. Hasanabadi, Amiri, Tajedini, Yazdi, Heidarali, Amali, Banazadeh, Mokhtari and Azizi, Huge myxoid liposarcoma of the esophagus: a case report. Acta Med Iran, 2011; 49(2): 118–21.

    PubMed  Google Scholar 

  17. Jakowski and Wakely, Rhabdomyomatous well-differentiated liposarcoma arising in giant fibrovascular polyp of the esophagus. Ann Diagn Pathol, 2009; 13(4):263–8.

    Article  PubMed  Google Scholar 

  18. Liakakos, Troupis, Tzathas, Spirou, Nikolaou, Ladas and Karatzas, Primary liposarcoma of esophagus: a case report. World J Gastroenterol, 2006; 12(7):1149–52.

    PubMed Central  PubMed  Google Scholar 

  19. Mandell, Brandwein, Woo, Som, Biller and Urken, Upper aerodigestive tract liposarcoma: report on four cases and literature review. Laryngoscope, 1999; 109(8): 1245–52.

    Article  CAS  PubMed  Google Scholar 

  20. Mansour, Fritz, Jacobs and Vellios, Pedunculated liposarcoma of the esophagus: a first case report. J Thorac Cardiovasc Surg, 1983; 86(3):447–50.

    CAS  PubMed  Google Scholar 

  21. Maruyama, Motoyama, Okuyama, Sasaki, Sato, Hayashi, Nanjo and Ogawa, Cervical approach for resection of a pedunculated giant atypical lipomatous tumor of the esophagus. Surg Today, 2007; 37(2):173–5.

    Article  PubMed  Google Scholar 

  22. Masumori, Yoshioka, Tanaka, Uchida, Higuchi, Maeda and Onda, [A case report of esophageal liposarcoma]. Nihon Geka Gakkai Zasshi, 1991; 92(7):885–8.

    CAS  PubMed  Google Scholar 

  23. Mica, Gianom, Bode, Jaklin and Hollinger, Rare cause of dysphagy: giant polypoid esophageal well-differentiated liposarcoma. Case Rep Gastroenterol, 2007; 1(1):7–14.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Moretti, Cimino, Vacca and Rubinato, Giant low-grade liposarcoma of distal esophagus. Eur J Cardiothorac Surg, 2011; 39(5):795.

    Article  PubMed  Google Scholar 

  25. Myung, Jeong, Han, Song, Moon, Kim, Kim, Byun, Kim and Chang, Well-differentiated liposarcoma of the oesophagus: clinicopathological, immunohistochemical and array CGH analysis. Pathol Oncol Res, 2011; 17(2):415–20.

    Article  PubMed  Google Scholar 

  26. Nagahama, A pedunculated liposarcoma of the esophagus : A case report and literature review. Ryukyu Medical Journal, 2005; 24(1):27–32.

    Google Scholar 

  27. Nakazawa, Kondo, Niu, Ma, Mochizuki, Kawasaki, Kawaguchi, Kono, Fujii and Katoh, Giant oesophageal liposarcoma mimicking spindle cell liposarcoma and containing eosinophilic cells with rhabdomyoblastic differentiation. J Clin Pathol, 2010; 63(5):469.

    Article  CAS  PubMed  Google Scholar 

  28. Pezzatini M, Liposarcoma of the esophagus: a case report. BMC Geriatrics, 2009; 9: (Suppl 1):A50.

    Article  Google Scholar 

  29. Ramacciato, Nigri and Valabrega, Clinical Challenges and Images in GI: image 2. A very rare case of dysphagia. Gastroenterology, 2008; 135(3):742,1019.

  30. Ruppert-Kohlmayr, Raith, Friedrich, Regauer, Preidler and Szolar, Giant liposarcoma of the esophagus: radiological findings. J Thorac Imaging, 1999; 14(4):316–9.

    Article  CAS  PubMed  Google Scholar 

  31. Saleh, Aljehani and Ahmad, Giant pedunculated esophageal liposarcoma associated with Hurthle cell thyroid neoplasia. Saudi Med J, 2013; 34(7):750–2.

    PubMed  Google Scholar 

  32. Salis, Albertengo, Bruno, Palau, Gonzalez Villaveiran, Lombardo, Villafane, Zorraquin and Ghigliani, Pedunculated liposarcoma of the esophagus. Dis Esophagus, 1998; 11(1): 68–71.

    CAS  PubMed  Google Scholar 

  33. Sui, Li, Zhao and Wang, Giant liposarcoma of the esophagus with Li-Fraumeni-like syndrome. Eur J Cardiothorac Surg, 2011; 40(5):1253–5.

    PubMed  Google Scholar 

  34. Torres-Mora, Moyer, Topazian, Alexander, Wu, Seys and Fritchie, Dedifferentiated liposarcoma arising in an esophageal polyp: a case report. Case Rep Gastrointest Med, 2012; 2012:141693.

  35. Watkin, Devouassoux-Shisheboran, Pedeutour, Lagarde, Salle, Ranchere-Vince, Baulieux and Barnoud, A first reported case of dedifferentiated liposarcoma of the esophagus with molecular diagnosis. J Gastrointest Cancer, 2011; 42(1):65–7.

    Article  PubMed  Google Scholar 

  36. Will, Lorenz, Urban and Meyer, Curative endoscopic resection of a huge pedunculated esophageal liposarcoma. Endoscopy, 2007; 39 Suppl 1: E15-6.

    Article  PubMed  Google Scholar 

  37. Xu, Xu, Hou and Tan, Primary pedunculated giant esophageal liposarcoma: case report. Dysphagia, 2008; 23(3): 327–30.

    Article  PubMed  Google Scholar 

  38. Yang, Shi, Li and Xu, Well-differentiated liposarcoma of esophagus. Chin Med J (Engl), 2006; 119(5): p. 438–40.

    Google Scholar 

  39. Yates and Collins, Case report: recurrent liposarcoma of the oesophagus. Clin Radiol, 1990; 42(5):356–8.

    Article  CAS  PubMed  Google Scholar 

  40. Yo, Chung, Jeong, Lee, An, Kwon, Rim and Hahm, Huge liposarcoma of esophagus resected by endoscopic submucosal dissection: case report with video. Clin Endosc, 2013; 46(3): 297–300.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Barile, Zugaro, Catalucci, Caulo, Di Cesare, Splendiani, Gallucci and Masciocchi, Soft tissue liposarcoma: histological subtypes, MRI and CT findings. Radiol Med, 2002; 104(3):140–9.

    CAS  PubMed  Google Scholar 

  42. Sugarbaker, Jaklitsch and Liptay, Thoracoscopic staging and surgical therapy for esophageal cancer. Chest, 1995; 107(6 Suppl):218S–223S.

    Article  CAS  PubMed  Google Scholar 

  43. McQueen, Montgomery, Dufour, Olney and Illei, Giant hypopharyngeal atypical lipomatous tumor. Adv Anat Pathol, 2010; 17(1):38–41.

    PubMed  Google Scholar 

  44. Tarbell, Thompson and Mauch, Thoracic irradiation in Hodgkin’s disease: disease control and long-term complications. Int J Radiat Oncol Biol Phys, 1990; 18(2):275–81.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of Interest

The authors have no conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Division of Thoracic Surgery, Brigham and Women’s Hospital, Boston VA Health Care System, Harvard Medical School, Boston, MA, USA

    A. Dowli, A. Mattar, D. Cohen & A. Lebenthal

  2. Division of Gastroenterology, Brigham and Women’s Hospital, Boston VA Health Care System, Harvard Medical School, Boston, MA, USA

    H. Mashimo

  3. Department of Pathology, Brigham and Women’s Hospital, Boston VA Health Care System, Harvard Medical School, Boston, MA, USA

    Q. Huang

  4. Department of Surgery, Brigham and Women’s Hospital, Boston VA Health Care System, Harvard Medical School, Boston, MA, USA

    A. Dowli, A. Mattar, D. Cohen, P. M. Fisichella & A. Lebenthal

Authors
  1. A. Dowli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Mattar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Mashimo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Q. Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. M. Fisichella
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Lebenthal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Lebenthal.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dowli, A., Mattar, A., Mashimo, H. et al. A Pedunculated Giant Esophageal Liposarcoma: a Case Report and Literature Review. J Gastrointest Surg 18, 2208–2213 (2014). https://doi.org/10.1007/s11605-014-2628-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-014-2628-8

Keywords

Search

Navigation