Malignant mesenchymoma is an interesting but very rare tumor in which malignant differentiation has occurred twice or more. We report a case of retroperitoneal malignant mesenchymoma consisting of osteosarcoma, leiomyosarcoma, liposarcoma and fibrosarcoma. Abdominal CT showed a large retroperitoneal mass with two separate and distinct parts, namely an area of prominent calcification and one of clearly enhancing solid components. The mass contained histologically distinct tumorous components with no histologic admixure at the interfaces. The densely calcified nodule corresponded to osteosarcoma, and the noncalcified clearly enhancing nodules to leiomyosarcoma, liposarcoma and fibrosarcoma.
Case Report ; Fibrosarcoma/*radiography ; Human ; Leiomyosarcoma/*radiography ; Liposarcoma/*radiography ; Male ; Mesenchymoma/*radiography ; Middle Age ; Osteosarcoma/*radiography ; Retroperitoneal Neoplasms/*radiography ; Tomography, X-Ray Computed

A giant esophageal liposarcoma showing rapid growth over 7 months is presented in 56-year-old man. It originated from the pharyngo-esophageal junction with a short stalk, and extended downward to the distal esophagus. A barium swallow study showed a large, sausage-like intraluminal mass in the dilated esophagus. CT and MR imaging showed a heterogeneous mass with a fatty component in the esophagus. A total laryngopharyngo-esophagectomy was performed and the histological diagnosis was of a well-differentiated liposarcoma.
Esophageal Neoplasms/*diagnosis/pathology ; Esophagus/radiography ; Human ; Liposarcoma/*diagnosis/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

PURPOSE: To describe the CT findings of primary liposarcoma of the mediastinum, and to correlate these with the pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the medical records, chest radiographs and CT scans of four male patients with histopathologically proven primary liposarcoma of the mediastinum treated between September 1996 and April 2002. The CT scans were analyzed by two radiologists, and final decisions were reached by consensus. They were analysed in terms of tumor size and location, enhancement pattern, the pattern of the fat component, calcification, mass effect, pleural effusion, lymph node enlargement, pericardial effusion, tumor extension to the costophrenic junction, and adjacent organ invasion. RESULTS: All patients presented with dyspnea and chest pain. Pathologic subtypes, which were well-differentiated and pleomorphic, were myxoid (n=2) and mixed (n=2). The transverse diameter of the mass ranged from 10.5 to 21 cm. All tumors were located in the anterior mediastinum, and all had lobulated margins. Soft-tissue attenuation predominance (n=2) occurred in the myxoid type, and roughly equal amounts of fat and soft-tissue attenuation (n=2) were present in the mixed type. A small area at calcification was seen in the mixed type (n=1). Mass effect on mediastinal structures was demonstrated in all patients. In three patients, the tumor draped around and conformed to the shape of the costophrenic junction. Chest wall invasion occurred in one patient. CONCLUSION: Findings of an anterior mediastinal location, fat attenuation, mass effect, the invasion of adjacent organs, and a lobulated margin strongly suggested mediastinal liposarcoma. CT attenuation of the lesions correlated closely with the degree of histologic differentiation.
Chest Pain ; Consensus ; Dyspnea ; Humans ; Liposarcoma* ; Lymph Nodes ; Male ; Mediastinum* ; Medical Records ; Pericardial Effusion ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Thoracic Wall ; Tomography, X-Ray Computed