Chu PY, Lin KH, Kao HL, Peng YJ, Huang TW. Three-dimensional image simulation of primary diaphragmatic hemangioma: A case report. World J Clin Cases 2019; 7(24): 4307-4313 [PMID: 31911912 DOI: 10.12998/wjcc.v7.i24.4307]
Corresponding Author of This Article
Tsai-Wang Huang, MD, PhD, Chief Doctor, Surgeon, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, Neihu District, Taipei 114, Taiwan. chi-wang@yahoo.com.tw
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Pei-Yi Chu, Kuan-Hsun Lin, Tsai-Wang Huang, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Hao-Lun Kao, Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Yi-Jen Peng, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Author contributions: Chu PY is the first author of this case report, and she wrote the case report and completed literature review; Lin KH was the assistant surgeon, and he made the 3D image constructor; Kao HL was the attending radiologist; Peng YJ was the attending pathologist; Huang TW was the attending surgeon; Huang TW made final editing and reconstruction of the paper for approval; all authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tsai-Wang Huang, MD, PhD, Chief Doctor, Surgeon, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, Neihu District, Taipei 114, Taiwan. chi-wang@yahoo.com.tw
Telephone: +886-2-87927167 Fax: +886-2-87927403
Received: September 13, 2019 Peer-review started: September 13, 2019 First decision: October 24, 2019 Revised: November 8, 2019 Accepted: November 15, 2019 Article in press: November 15, 2019 Published online: December 26, 2019 Processing time: 102 Days and 18.1 Hours
Abstract
BACKGROUND
Fewer than 200 cases of diaphragmatic tumors have been reported in the past century. Diaphragmatic hemangiomas are extremely rare. Only nine cases have been reported in English literature to date. We report a case of cavernous hemangioma arising from the diaphragm. Pre-operative three-dimensional (3D) simulation and minimal invasive thoracoscopic excision were performed successfully, and we describe the radiologic findings and the surgical procedure in the following article.
CASE SUMMARY
A 40-year-old man was referred for further examination of a mass over the right basal lung without specific symptoms. Contrast-enhanced computed tomography revealed a poorly-enhanced lesion in the right basal lung, abutting to the diaphragm, measuring 3.1 cm × 1.5 cm in size. The mediastinum showed a clear appearance without evidence of abnormal mass or lymphadenopathy. A preoperative 3D image was reconstructed, which revealed a diaphragmatic lesion. Video-assisted thoracic surgery was performed, and a red papillary tumor was found, originating from the right diaphragm. The tumor was resected, and the pathological diagnosis was cavernous hemangioma.
CONCLUSION
In this rare case of diaphragmatic hemangioma, 3D image simulation was helpful for the preoperative evaluation and surgical decision making.
Core tip: Diaphragmatic hemangioma is rare, and its diagnosis is challenging. We present the case of a 40-year-old man with incidental abnormal findings in chest imaging studies. Contrast-enhanced computed tomography revealed a poorly-enhanced lesion in the right basal lung, abutting to the diaphragm. Three-dimensional (3D) image simulation revealed a supra-diaphragmatic tumor. Successful tumor resection followed by primary repair of diaphragm was performed via minimally invasive thoracoscopic surgery. The pathological findings confirmed a primary cavernous hemangioma of the diaphragm. In this rare case of diaphragmatic hemangioma, 3D image simulation was helpful for the preoperative evaluation and surgical decision making.
