Multiple surgical excision for recurrent primary mediastinal liposarcoma.

Liposarcoma is one of the most common soft tissue malignancies, occurring mostly in the extremities and retroperitoneal cavities, and occasionally in the mediastinum of the thoracic cavity. Here, we present a patient undergoing four operations over a period of 33 years because of repeated recurrence of mediastinal liposarcoma. A 34-year-old woman underwent her first surgery for mediastinal liposarcoma in 1986. Ten years later, a recurrent tumour was found during follow-up. The patient underwent a second operation for complete excision. The pathology was liposarcoma, partly myxoid and partly dedifferentiated. The patient remained tumour-free for 22 years, until one year ago, when a third operation was performed to resect the recurrent tumour which was myxoid liposarcoma. Unfortunately, upon computed tomography imaging three months later a fatty mass was spotted which increased rapidly in size. The patient underwent further surgery to achieve radical excision of the recurrent liposarcoma. Postoperative recovery was uneventful, and a follow-up examination showed no recurrence to date. For mediastinal liposarcoma, surgical removal is the treatment of choice. Considering that the tumour is prone to recurrence, the lesion should be removed as thoroughly as possible in the first operation. If the tumour recurs repeatedly, multiple resections are beneficial to patient survival on most occasions.