Extensively Calcified Hemangioma of the Diaphragm with Increased 99mTc-Hydroxymethylene Diphosphonate Uptake.

Abstract

A 31-year-old womanvisited an out-patient clinic, because of low-grade fever and general fatigue. She was referred to our hospital and admitted for examination of an abnormal shadow which had been found on the chest radiograph. She had experienced faint right lateral chest pain several times on the deep inspirations. Chest radiography showeda mass shadowwith calcification in the right lower lung field on the mediastinal side. Chest radiographic computed tomography showed a 6x6 cm tumor in the right lung field. There were low-density areas with septae inside the tumor. Bone scintigraphy showed extremely high uptake of "mTc-HMDP in the tumor. After surgical resection and pathological examination, we concluded that the tumor was an extensively calcified benign hemangiomaof the diaphragm. (Internal Medicine 39: 576-578, 2000)

Tumors of the Diaphragm

“…Wiener, 26 Cada 13 Angiofibroma 3 Wiener 26 Fibroma 3 Wiener 26 Hemangioma 3 Ohsaki, 65 Kaniklides, 23 histologic patterns seen are spindle cell and medullary thymoma, mixed pattern of lymphocyte and lymphocyte-rich thymoma, and thymoma resembling the normal thymic epithelial cells with subtypes characterized by increasing epithelial/ lymphocyte ratio. Thymic tumors can form ''drop metastases,'' tumors that form within the pleural space and that are thought to be secondary to direct shedding of tumor cells.…”

Cavernous hemangioma arising from the diaphragm

“…Only 9 cases of diaphragmatic hemangioma have been reported previously in the literature. 1,[4][5][6][7][8][9][10][11] Hemangiomas are classified into 3 types: capillary, cavernous, and venous. Capillary hemangiomas are the most common, and cavernous hemangiomas are less frequent than capillary hemangiomas, although they share common age and anatomic distributions.…”

“…1 Radiologically, most diaphragmatic tumors appear as a smooth or lobulated soft tissue mass protruding into the inferior portion of the lung. 4 Tumors arising in the region of the diaphragm most likely originate from an adjacent organ rather than the diaphragm itself. It is important to differentiate a primary diaphragmatic tumor from an invasive tumor emanating from an adjacent structure or a metastatic deposit from a distant neoplasm.…”

A rare primary diaphragmatic hemangioma successfully treated by laparoscopic surgery: Report of a case

“…4 A hemangioma of the diaphragm is extremely rare, and its incidence is about 5% among all the primary diaphragmatic tumors reported in the literature. 2,5 There are no common symptoms in primary diaphragmatic tumors because of their varied pathological features. However, due to the growth of such a tumor, symptoms such as pain, cough, dyspnea, or upper abdominal discomfort are observed.…”

“…2,4 A preoperative diagnosis of diaphragmatic tumors is also very diffi cult to make, even with the latest imaging modalities, including CE-CT, magnetic resonance imaging, and PET/CT. 5,6 The only way to confi rm the diagnosis is to resect the tumor and examine the pathological specimen. Furthermore, it was very diffi cult to make a diagnosis of "a primary tumor derived from the diaphragm" in the current case because of both the rare pathological and macroscopically pedunculated features.…”