Abstract
We report the case of a 71-year-old woman who developed a 43-mm mass lesion that was detected by CT on postoperative follow-up examination of right breast cancer. The lesion was preoperatively diagnosed as a gastrointestinal stromal tumor (GIST) that developed outside the gastric wall. First, we carried out a diagnostic laparoscopy to confirm the tumor site. On observation, we found that the tumor originated mainly from the diaphragm. Securing a sufficient margin, we laparoscopically resected a 4-cm × 5-cm section of the diaphragm, including the tumor. The diaphragmatic defect was repaired using Gore-Tex®. Histopathological examination revealed that the tumor was a rare primary diaphragmatic neurilemmoma. For tumors developing around the diaphragm, identification of the primary lesion is often difficult because of the presence of many neighboring organs, including the liver, stomach, and esophagus.
Therefore, it is difficult to determine whether a diaphragmatic tumor should be accessed by the thoracic approach or abdominal approach. Diagnostic laparoscopy was feasible for determining the appropriate approach and resection procedure. To our knowledge, this is the first case of laparoscopically resected primary diaphragmatic neurilemmoma.
