# Dedifferentiated Mediastinal Liposarcoma: A Case Report

## TL;DR

This case report describes a rare dedifferentiated mediastinal liposarcoma in an elderly man, emphasizing the challenges in treatment and the importance of complete surgical removal.

## Contribution

The novelty lies in presenting a rare case of mediastinal dedifferentiated liposarcoma with clinical and histological insights.

## Key findings

- The patient experienced local recurrence and died four months after surgery due to incomplete resection.
- Radical surgical resection is critical to prevent recurrence, while adjuvant therapies may help in some cases.
- Surgical debulking can provide symptomatic relief when complete removal is not possible.

## Abstract

Liposarcoma is the most common soft tissue sarcoma type in adults, originating mainly from the retroperitoneum and lower extremities. Mediastinal liposarcomas constitute an extremely rare clinical entity of mesenchymal origin. Among subtypes, dedifferentiated liposarcoma is characterized by poor survival, but little is known about its biological behavior. We present the case of a 78-year-old male patient who presented with vague symptoms, predominantly dyspnea and chest pain. Imaging revealed a large mediastinal mass and surgical resection was performed in a piecemeal manner due to the inability to achieve a microscopically negative surgical margin (R0 resection) for the residual tumor. Histological examination confirmed the diagnosis of dedifferentiated liposarcoma. The patient’s postoperative course was uneventful, with discharge from the hospital on the 10th postoperative day. However, local recurrence was detected after two months and the patient died four months after the operation. The present case report highlights the importance of radical excision for the prevention of local recurrence and the presentation of histological characteristics of this tumor. Radical surgical resection remains the fundamental treatment, while chemo and radiotherapy may have an adjuvant role. In cases of inability to obtain negative margins, surgical debulking can offer symptomatic relief.