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Weekly Chest CasesArchive of Old Cases

Case No : 1265 Date 2022-01-17

  • Courtesy of Kyongmin Sarah Beck / Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea
  • Age/Sex 46 / M
  • Chief ComplaintAbnormality on chest x-ray
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6

Diagnosis With Brief Discussion

Diagnosis
thymoliposarcoma
Radiologic Findings
Figs 1-2. Chest PA (A) and right lateral (B) images show a large triangular-shaped mass in the right anterior mediastinum, with obscuration of the right hear border.
Figs 3-5. Chest CT scans reveal a large fatty mass (or prominent pericardial fat pad) showing fluid collections and fat haziness and containing a small rim-enhancing round mass with an internal round nonenhancing portion in the right anterior mediastinum.
Fig 6. MRI of the chest reveals a large fatty mass with internal strands, soft tissue lesion, and a small round rim-enhancing lesion in the right anterior mediastinum.
Brief Review
Gross specimen revealed a 15.3 x 12.5 cm sized anterior mediastinal mass, and the final pathology was thymoliposarcoma.

Thymoliposarcoma is a very rare, large-sized mesenchymal tumor. Patients are usually asymptomatic at diagnosis. The tumor is usually lobulated and encapsulated and expands without infiltrating into the neighboring structures. Thymoliposarcoma contains varying proportions of fibrosis and yellow adipose tissue. The mean age of the diagnosis is 56 years with a slight male predominance. On CT, thymoliposarcomas usually present as anterior mediastinal tumors with predominantly soft tissue density and some foci of fat. The mainstay of treatment is surgical resection of the tumor, and the prognosis is usually favorable.
References
1. Alhames S, Ghabally M. Enbloc resection of the largest thymic liposarcoma: A case report with literature review. Annals of Medicine and Surgery. Volume 59 2020; 204-206.
2. S.J. Howling, J.D. Flint, N.L. Muller Thymoliposarcoma, CT and pathologic findings, Clin. Radiol. 54 (1999) 54.
Keywords
thymoliposarcoma,

No. of Applicants : 92

▶ Correct Answer : 5/92,  5.4%
  • - , Canada ASHISH GUPTA
  • - , Italy PAOLO BALDASSARI
  • - Manipal HealthMap , India SHASHANK SOOD
  • - Eskisehir Sehir Hastanesi , Turkey MURAT SAHIN
  • - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
▶ Correct Answer as Differential Diagnosis : 4/92,  4.3%
  • - , Japan CHIAKI SATO
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
▶ Semi-Correct Answer : 44/92,  47.8%
  • - , Japan HIROAKI ARAKAWA
  • - , Japan JUN KANZAWA
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Ulsan University Hospital , Korea (South) SOYEOUN LIM
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - National Center of Neurology and Psychiatry , Japan MOTO NAKAYA
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) SEONGSU KANG
  • - Other , Korea (South) EUN HO JANG
  • - Korea University Ansan Hospital , Korea (South) HYO YOUNG KIM
  • - Osaka University , Japan AKINORI HATA
  • - Kaneda hospital , Japan HIROFUMI MIFUNE
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - , Korea (South) SUNHYANG LEE
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Other , Korea (South) JOO HEE KIM
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Kyoto University Hospital , Japan YASUHISA KURATA
  • - , Korea (South) EUNJIN LEE
  • - , Korea (South) CHAEHUN LIM
  • - , Korea (South) YEONG UK HWANG
  • - , United States HIROAKI TAKAHASHI
  • - MAGNUM DIAGNOSTICS - Goa INDIA , India PARESH K DESAI
  • - Mallinckrodt Institute of Radiology , United States NAGANATHAN MANI
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Other , Korea (South) MINSU KIM
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - , Qatar NABIL SHERIF MAHMOOD
  • - Osaka city university Hospital , Japan TATSUSHI OURA
  • - Other , Korea (South) SEONG WON JANG
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - Osmania Medical College, Hyderabad , India PURUSHOTHAMA RAO TUMMALA
  • - Other , Korea (South) KYU-CHONG LEE
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - TAKANA HAYASHI
  • - , Japan KAZUMA TERAUCHI
  • - Private sector , Greece VASILIOS TZILAS
  • - , Japan YUMI MAEHARA
  • - , Japan YUKI HAYASHI
  • - , Korea (South) HM PARK
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Jiangsu province hospital , China WANGJIAN ZHA
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