Isolated diaphragmatic metastasis originated from adenocarcinoma of the colon

Metastasis of endometrial cancer to right hemidiaphragm: A case report

INTRODUCTION

Tumors of the diaphragm are uncommon. The overwhelming number of cases is metastatic combined with metastases to the liver, lungs and other organs. Only a minority of cases are described as solitary lesions.

CASE PRESENTATION

Fifty-five years old female with a history of radical curative surgery for pT3N0M0 endometrial cancer eight years ago was admitted to the Department of Thoracic Surgery with a feeling of discomfort in the right hypochondrium. The contrast-enhanced MDCT revealed a large, well-circumscribed lesion of the right hemidiaphragm deforming upper contour of the liver. A clear boundary between the lesion and the liver suggested former's diaphragmatic origin. PET-CT did not show any distant metastasis. Intraoperative revision revealed a tumor growing from the dome of the diaphragm with well-defined contours and without any signs of lung involvement. The diaphragmotomy was performed. The morphological study with immunohistochemistry showed an endometrial carcinoma metastasis to the diaphragm.

CONCLUSION

The diaphragm lesions can have various etiology, but a probability of tumor metastasis after a previous radical surgery should not be excluded. Preoperative differential diagnostics can be difficult, leaving surgical treatment followed by a pathology study as the most informative diagnostic method of tumor morphology.

Successful diagnosis of an occult fallopian tube carcinoma detected from the diaphragm metastasis

We herein reported a rare case of an occult fallopian tube carcinoma first detected from the diaphragm metastasis. An 83-year-old woman who had a 30-mm tumor on the right diaphragm underwent radical resection. Pathologically, the tumor was diagnosed as a high-grade serous adenocarcinoma, suggesting metastasis from the pelvic visceral carcinoma. Although the primary site could not be detected by imaging examinations, laparoscopy revealed multiple peritoneal disseminations; therefore, total hysterectomy was performed. Finally, microscopic tumor invasion into the right fimbriae of the fallopian tube was found. A precise and detailed pathological and immunohistochemical examinations of the resected metastatic diaphragm tumor helped us obtain a proper diagnosis of the primary lesion and treat the patient appropriately. Since it is difficult to diagnose diaphragm tumors before surgery based on the anatomy, surgical options have played an important role in their treatment and diagnosis clinically.

Rare Thyroid Cartilage and Diaphragm Metastases from Lung Cancer Visualized on F-18 FDG-PET/CT Imaging

Positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) has evolved as a useful imaging modality in the assessment of a variety of cancers, especially for tumor staging and post treatment monitoring. It provides metabolic information. Although, when used alone, relative lack of anatomic landmarks, is a major limitation of PET imaging, this limitation of PET imaging is overcome by the availability of integrated PET/CT imaging. PET and CT images are acquired in one procedure, yielding fused anatomical and functional data sets. Studies with integrated PET/CT imaging have shown promising results. In this case, we present an interesting integrated PET/CT imaging in a lung cancer patient with rare, diaphragm and thyroid cartilage metastases.

Conflict of interest:None declared.