CTICasesMassive Mediastinal Liposarcoma
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Imaging findings
Initial imaging in 2011 revealed a large, extra-parenchymal lesion in the middle to superior mediastinum, composed of fat and soft tissue, compressing the esophagus. Biopsy indicated a low-grade liposarcoma, with PET showing minimal activity. By 2015, the lesion had grown substantially, appearing much larger and more aggressive, extending inferiorly.
Key takeaways
Mediastinal liposarcomas can achieve impressive sizes and may undergo dedifferentiation to a higher grade over time. Initial low-grade biopsy results, particularly from percutaneous approaches, may not capture all components of the tumor. PET activity can be low even in evolving or aggressive sarcomas. While often found in the inferior mediastinum, these tumors can originate high near the thoracic inlet and great vessels.
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