Lipomatous tumors of the anterior mediastinum with muscle differentiation: a clinicopathological and immunohistochemical study of three cases.

[well-differentiated liposarcoma]

Three cases of primary lipomatous tumors of the anterior mediastinum with prominent muscle differentiation are presented . The patients were two women and one man between the age of 52 and 68 years . All patients presented with progressive shortness of breath . Radiographically , all patients demonstrated anterior mediastinal tumors which were surgically resected . In two cases , the gross findings were those of circumscribed tumors , while one lesion was described as an ill-defined and unencapsulated neoplasm . Histologically , two cases corresponded to a well-differentiated liposarcoma , while the third was a thymolipoma . Extensive areas of smooth muscle were identified in one of the liposarcomas , while the other contained areas of mature skeletal muscle . The thymolipoma displayed a prominent myoid component . Immunohistochemical studies for muscle markers including smooth muscle actin , desmin , and myoglobin showed positive staining in the corresponding components . Follow-up information showed that one patient with liposarcoma died 60 months after initial diagnosis , while the other two patients remain alive and well 16 and 36 months after diagnosis , respectively . The current cases highlight the spectrum of muscle differentiation that can be seen in adipose tumors of the anterior mediastinum and also emphasize the difficulty that such a diagnosis can pose when confronted with limited mediastinoscopic biopsies .

Diseases
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Diseases presenting "muscle markers" symptom

cadasil

pleomorphic liposarcoma

well-differentiated liposarcoma

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