Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4307
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
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.
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.
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.