CTICasesMyxoid Liposarcoma of the Mediastinum
Imaging findings
CT and MRI demonstrate a large, multi-loculated, complex mass primarily located in the anterior mediastinum, displacing the mediastinal structures to the contralateral side. On CT, the mass exhibits near-fluid attenuation, mimicking a complex cyst. On MRI, the lesion is hyperintense on T2-weighted imaging with internal septations, shows areas of delayed contrast enhancement, and contains a focal area of high T1 signal representing hemorrhage. No significant macroscopic fat is identifiable within the mass on fat-saturated sequences.
Key takeaways
Myxoid liposarcoma of the mediastinum is a rare malignancy that typically presents with very little to no detectable macroscopic fat on cross-sectional imaging. Because they are highly myxoid and water-rich, these tumors frequently mimic benign, complex multi-loculated cystic lesions (such as lymphangiomas or thymic cysts) on both CT and MRI. Histopathologic evaluation is necessary for definitive diagnosis when atypical features are present.
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