Spontaneous diaphragmatic rupture related to local invasion by retroperitoneal liposarcoma

Ann R Coll Surg Engl. 2012 Jan;94(1):e18-9. doi: 10.1308/003588412x13171221499423.

Abstract

We report a case of the female patient who was admitted to the hospital because of syncope experienced while climbing stairs. Diagnostic workup raised the suspicion of a right diaphragmatic rupture that was eventually confirmed by surgery (right-sided thoracotomy). Surgery also revealed tissue protruding through the rupture site from within the retroperitoneum that was proven subsequently to be a dedifferentiated liposarcoma. Second surgery was performed to completely remove the liposarcoma tissue and repair a coincident old right lumbar region hernia. The patient recovered fully. Spontaneous rupture of the diaphragm is rare and this is especially true for the right hemidiaphragm. We report the first case of diaphragmatic rupture caused by local infiltration by a retroperitoneal liposarcoma. This and similar reports emphasise that in cases with high clinical suspicion of diaphragmatic rupture, diagnosis should be pursued even in the absence of a preceding traumatic event.

Publication types

  • Case Reports

MeSH terms

  • Diaphragm*
  • Female
  • Humans
  • Liposarcoma / complications*
  • Liposarcoma / pathology
  • Middle Aged
  • Muscular Diseases / etiology*
  • Neoplasm Invasiveness / pathology
  • Retroperitoneal Neoplasms / complications*
  • Retroperitoneal Neoplasms / pathology
  • Rupture, Spontaneous / etiology

Supplementary concepts

  • Retroperitoneal liposarcoma