PMC4560154_01
Preoperative computed-tomography images. Computed tomography of a horizontal dislocation and b coronal dislocation showing a large mass in the pericardium anterolateral to the main pulmonary artery (A). Horizontal dislocation also showed a mass in the posterior mediastinum posterior to the bronchi (B). PA pulmonary artery
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Fig1
This mass extended laterally to the ascending aorta and aortic arch, anterolaterally to the main pulmonary artery, and anteriorly to the left pulmonary artery (Fig. 1).
Intraoperative picture. A large tumor can be seen anterolateral to the main pulmonary artery (T). Ao ascending aorta, RV right ventricle
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Fig2
Moderate adhesion was present between the heart and chest wall, and we safely exposed the right ventricle, right atrium, and ascending aorta (Fig. 2).
Picture of the en bloc resected tumors. Two large masses were anterolateral to the main pulmonary artery, and one small mass was adjacent to the right ventricle. All of them were soft and mucinous
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Fig3
A mucinous mass measuring approximately 30 x 20 x 10 mm, which was not recognized before the operation, was observed between the diaphragm and right ventricle and was resected (Fig. 3). We performed en bloc resection of two of the three masses (Fig. 3), but the other was vulnerable and disintegrated.
Histological findings of the resected tumors. Histological findings showing that almost all of the tumors were myxoid liposarcomas (a, hematoxylin-eosin, x100) and a part of the tumor adjacent to the right ventricle was round-cell liposarcoma (b, hematoxylin-eosin, x200)
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Fig4
The pathological diagnosis of the large masses was myxoid liposarcoma, and that of the smaller mass was myxoid and round-cell liposarcoma (Fig. 4).
Postoperative computed-tomography images. Computed tomography showed that the pericardial tumor was almost totally resected and there was no evidence of recurrence
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Fig5
Computed tomography 3 months after the cardiac surgery showed no evidence of recurrence in the pericardium (Fig. 5).