Diaphragmatic Tumors

Diaphragmatic tumors are extremely rare and may be either primary (originating in the diaphragm) or secondary (from nearby or distant spread). These tumors can be benign or malignant, and symptoms often arise from mass effect on surrounding organs (lungs, liver, stomach).

🧬 Types of Diaphragmatic Tumors

🔹 Primary Tumors (very rare)

These originate in the diaphragm itself.

✅ Benign:

• Lipoma – fat tissue tumor
• Fibroma – fibrous tissue
• Neurofibroma – nerve sheath tumor

❗ Malignant:

• Fibrosarcoma
• Rhabdomyosarcoma
• Mesothelioma (can arise from diaphragmatic pleura)

🔹 Secondary (Metastatic) Tumors

• More common than primary tumors
• Spread from:
  • Lung cancer
  • Liver cancer
  • Breast cancer
  • Ovarian or gastrointestinal cancers

⚠️ Symptoms

Often nonspecific and depend on tumor size/location:

• Chest or upper abdominal pain
• Shortness of breath
• Shoulder pain (referred via phrenic nerve)
• Cough or hiccups
• Weight loss or systemic symptoms (in malignancy)
• Bowel or stomach displacement symptoms (rare)

🧪 Diagnosis

🖼️ Imaging:

• CT scan (chest and abdomen) – best for identifying and localizing the mass
• MRI – for soft tissue characterization
• Ultrasound – useful for detecting superficial or liver-adjacent lesions
• PET-CT – evaluates for metastasis

🔬 Tissue Diagnosis:

• Biopsy via image-guided needle or surgical exploration (thoracoscopy or laparoscopy)

💊 Treatment

🔹 Benign Tumors:

• Surgical excision is typically curative
• Observation in asymptomatic, small lipomas may be appropriate

🔹 Malignant Tumors:

• Wide surgical resection (may involve diaphragm reconstruction)
• Chemotherapy or radiation (depending on tumor type)
• Palliative care if extensive spread

🛡️ Prognosis

📍 Differential Diagnosis

May mimic:

• Subphrenic abscess
• Diaphragmatic hernia
• Hepatic or pleural tumors
• Pericardial cysts