Diagnosis and Treatment of Giant thoracodorsal Liposarcoma: A Case Report

Kailin Liu¹Ningning Ren^1,2Peng Zhao¹Zhihao Wang¹Baoyan Zhao¹Xia Li^3*Yuyang Li^1*Chong Geng^1*

• ¹Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
• ²Department of Breast Surgery, The Second Hospital of Zhengzhou University, Zhengzhou, China
• ³Department of Ultrasonography, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China

Rationale: Liposarcoma was a prevalent malignant tumor of soft tissue. But those in the thoracic and back regions are rare and surgery is particularly challenging due to their complex anatomical structures. Case presentation: A 90-year-old male was admitted to the hospital due to a massive lump in the thoracodorsal region. Computerized tomography imaging revealed a large heterogeneous lesion with lipid density in the left axillary chest wall area, with a maximum cross-sectional area of approximately 17.4×14.2 cm, Histopathologic report showed a well differentiated liposarcoma. Clinical discussion: Early detection and timely intervention of liposarcoma are critical, particularly for large liposarcomas in thoracodorsal region because of the surrounding vital structures, such as the brachial plexus, axillary vein, and axillary artery. We found that the liposarcoma was infiltrated by M2 macrophages, with the central region exhibited high rates of M0 macrophages and Treg cells. This immunosuppressive tumor microenvironment may provide a potential target for the development of immunotherapeutic strategies.