Liposarcoma of the Left Breast

A 47- year- old female presented with a 19-centimeter tumor of the left breast. Core biopsy was inconclusive and surgical biopsy revealed well differentiated liposarcoma. Computed tomography of the thorax showed a 19 cm diameter tumor, of similar density to adipose tissue, infiltrating the thoracic wall and invading the underlying intercostal space, but not involving the lungs. No distant metastases were identified. A mastectomy was performed, with en bloc resection of the pectoralis major muscle, 10-centimeter segments of two ribs together with the involved intercostal space, and a 10x6cm area of the underlying parietal pleura where tumor was indenting through the intercostal space. At the posterior margin of the resection pericardium was left intact as it was clear of the tumor. The defect in the thoracic wall was covered with polypropylene mesh and rotational skin flaps. Two drains were inserted,- one into the pleural cavity, and the other beneath the skin flaps. Histopathological examination revealed a well differentiated 19x10x9cm liposarcoma, not infiltrating the excised ribs, although indenting the intercostal space. All but the posterior margin were clear of tumor by 2 centimeters. The postoperative course was uneventful and the patient is currently receiving radiotherapy.