FIBROMATOSIS OF THE DIAPHRAGM -A CASE REPORT-

Abstract

Primary tumors of the diaphragm are very rare, and we often have difficulties in differentiation from other tumors of adjacent organs. Here a case of fibromatosis originated from the diaphragm is reported.
A 15-year-old male student complained of abdominal tumor in the right upper quadrant. The chest X-ray examination showed a mild elevation of the right diaphragm. Ultrasonography and CT scanning revealed an ill-defined large mass at the level of the left inner segment of the liver.
A tumor of the liver was suspected and laparotomy was carried out. During surgery a large hard mass was found to arise in the right diaphragm, and to protrude into the abdominal cavity to compress the liver. There was no adhesion nor invasion to the adjacent organs including the liver. The tumor was excised with a part of the right hemidiaphragm and 4 ribs. The excised tumor measures 16×12.5×8 cm and weighed 640 gm.
On histological examination this tumor contained the components of a fibromatosis characterized by interlacing pattern of spindle cells and collagen fibers. There has been no sign of recurrence one year after operation.
We are able to collect a total of 53 cases with primary diaphragmatic tumor from the Japanese literature. Of the 53 cases fibromatosis was seen only in one case.