Resection of a large anterior mediastinum myxoid liposarcoma via clamshell thoracotomy in a resource-limited setting: A rare case report and literature review

Background: Mediastinal liposarcoma is an extremely rare malignant tumor of adipocytic differentiation, comprising less than 1 % of all liposarcomas. The majority occur in the lower extremities, with approximately 75 % of cases. Myxoid liposarcoma of the anterior mediastinum can present similarly to other thoracic pathologies. Case presentation: We present the case of a 36-year-old female who presented with a 14-day history of worsening dyspnea at rest, along with swelling of the upper extremities and face. On examination, distended neck and anterior chest veins were observed. Imaging studies revealed a large anterior mediastinal mass causing extrinsic compression of adjacent structures and a mediastinal shift to the right. Following stabilization, the patient underwent successful surgical resection of the mass. Discussion: Myxomatous liposarcoma is a very rare tumor located in the mediastinum that presents with symptoms resembling other lung diseases. Common complaints include chest pain, shortness of breath, and difficulty swallowing. Diagnosis is largely based on radiological imaging or histological examination after surgery. The primary treatment involves surgery and occasionally chemotherapy. Prompt diagnosis and timely treatment enhance the likelihood of positive outcomes for those affected. Conclusion: This case underscores the importance of considering mediastinal liposarcoma in the differential diagnosis of patients presenting with chronic cough and unquantified weight loss, especially when symptoms escalate into conditions such as superior vena cava syndrome. Early detection and timely treatment are crucial for improving outcomes. This case contributes valuable insight, particularly relevant to managing complex tumors in resource-limited settings.