Affiliation:
1. National Medical Research Center of Rehabilitation and Balneology
2. Penza State University
3. Clinic for Diagnostics and Management on Izmaylova
4. Penza Institute for Further Training of Physicians – Branch Campus of the Russian Medical Academy of Continuous Professional Education
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.
Publisher
Moscow Regional Research and Clinical Institute (MONIKI)
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