A diaphragmatic tumor mimicking gastric neoplasm: a clinical case report

P. Burko, M. G. Fedorova, R. R. Iliasov, I. N. Mozhzhukhina
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Abstract

The vast majority of patients with tumors arising from the diaphragm do not have any specific clinical symptoms, therefore, computed tomography (CT) and magnetic resonance imaging (MRI) are the techniques required for the diagnosis. This is particularly relevant when a  pathological mass has grown to an extent producing a “mass effect” on the adjacent organs. In some cases, clinical symptoms of arise due to the local invasion of the neoplasm to the adjacent tissues or distant metastases. We present a rare clinical case of a mesenchymal diaphragmatic tumor in a  34-year-old patient. After a  review of her clinical status and imaging of the abdomen, including CT and MRI, the preliminary diagnosis of the gastric neoplasm of uncertain behavior (D37.1) was made, despite the initial diagnostic assumption of the exogastric location of the mass based on MRI. After careful consideration of the diagnostic assessment results, a  multidisciplinary decision was made to perform laparoscopic resection of the mass. The intraoperative finding was a  tumor originating from the left diaphragmatic cupula with no involvement of the stomach. The patient's recovery was uneventful. Pathological examination revealed a solitary calcifying fibrous tumor of the diaphragm. This clinical case shows that a  mass arising from the diaphragm can mimic one arising from the gastric fundus, leading to an incorrect diagnosis and subsequent inappropriate management.
模拟胃肿瘤的横膈膜肿瘤1例临床报告
绝大多数横膈膜肿瘤患者没有任何特定的临床症状,因此,计算机断层扫描(CT)和磁共振成像(MRI)是诊断所需的技术。当病理肿块发展到对邻近器官产生“肿块效应”的程度时,这一点尤为重要。在一些病例中,临床症状是由于肿瘤局部浸润到邻近组织或远处转移引起的。我们报告一个罕见的临床病例间充质膈肿瘤在一个34岁的病人。在回顾了患者的临床情况和腹部影像学(包括CT和MRI)后,初步诊断为行为不确定的胃肿瘤(D37.1),尽管最初的诊断假设是基于MRI肿块位于胃外。在仔细考虑诊断评估结果后,多学科决定进行腹腔镜肿物切除术。术中发现肿瘤起源于左侧膈丘,未累及胃。病人的康复平安无事。病理检查显示膈肌单发钙化纤维瘤。这个临床病例表明,横膈膜上的肿块可以模仿胃底上的肿块,导致错误的诊断和随后不适当的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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