Aliena Badshah, Zoia Ehsan Khattak, Israr Khan, Arooba Naeem, Mohammad Humayub.
Pleomorphic liposarcoma presenting as extracardiac mediastinal mass leading to cardiac compression.
J Med Sci Jan ;29(01):52-5.

A 45-year-old male presented with a 3-month history of fever associated with dyspnea, orthopnea, weight loss, chest pain, and anorexia. Past history was notable for cigarette smoking of 5 packs per year. Examination findings suggested clubbing, raised jugular venous pulse and pedal edema. Characteristic findings on systemic examination were displaced apex beat, sternal heave, bibasilar crepitations, distended abdomen, and presence of shifting dullness. Echocardiography revealed an extracardiac mass collapsing mostly the right side of the heart. Later, multidetector computed tomography scan (MDCT) was done which detected a mediastinal mass crossing midline, significantly compressing right sided cardiac chambers, adjacent segments of major arteries and veins, and displaced esophagus to the left. An ultrasound guided biopsy confirmed the diagnosis of pleomorphic liposarcoma. Although it turned out to be a surgical case, but the objective of reporting this case of pleomorphic liposarcoma is to keep our differentials broad when we get cases with typical cardiac symptoms. Sometimes the etiology could be extracardiac.

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