BACKGROUNDClear cell sarcoma (CCS) of soft tissue is a rare malignant soft tissue sarcoma usually reported to locate at distal end of extremities and rarely at trunk. Herein, we report a case of CCS in pleural cavity.CASE SUMMARYA 31-year-old male was admitted for an uncertain mass in left pleural cavity in routine physical examination without any symptoms. A VATS surgery was performed to remove the tumor. The pathological finding displayed a cystic mass with 6.5 cm at the longest diameter, dark red in section and cysts could be found locally. A strong expression of S-100, HMB45 and Vimentin was detected in immunohistochemical staining, which was inclined to the diagnosis of the CCS of soft tissue. The patient refused chemotherapy, radiotherapy and targeted therapy because of the personal financial situation. Follow-up computed tomography scans were done at the 90th postoperative day and the 180th postoperative day, and no obvious sign of recurrence was found till now.CONCLUSIONCCS of soft tissue also can be found in pleural cavity although in an extremely rare incidence. Radical resection is useful to improve the prognosis.

Rationale:The case of parasternal diaphragmatic hernia is relatively rare in adults. The best way for the treatment of diaphragmatic hernia is to receive operation, yet which surgical method is the best remains unclear.Patient concerns:An elderly woman in the hospital was complaining about upper abdominal pain that was complicated by the parasternal diaphragmatic hernia. Such state was found accidentally in a car accident and diagnosed by a computed tomography (CT) scan.Diagnosis:Parasternal diaphragmatic hernia.Interventions:Laparoscopic surgery was performed. The hernial component was easily drawn back into the abdominal cavity, and hernia sac was resected. Closure hernia sac underwent full-thickness U-shaped transabdominal wall sutures with 3-0 Prolene (ETHICON) after straightening the needle without a mesh.Outcomes:The patient recovered quickly without postoperative complication. The hospital stay was 2 days. There was no recurrence and symptoms at a 6-month follow-up.Lessons:Laparoscopic extracorporeal repair without using a mesh is a safe, quick, and effective approach. It seems to be an effective treatment of the parasternal diaphragmatic hernia, in particular for elderly patients.