A case of diaphragmatic endometriosis diagnosed by laparoscopic surgery

Saki Tsurue, Taro Kuwayama, Fumio Nomura, Keigo Tezuka, Koyuki Uemura, Miwa Masuda, Munetaka Masuda, Yoshimasa Bomoto, Masanori Isobe
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2025 · vol. 41(2) , pp. 99–104 · doi:10.5180/jsgoe.41.2_99 · W4416805362
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper describes a rare case of diaphragmatic endometriosis, a condition where endometrial tissue implants on the diaphragm, estimated to occur in less than 1.5% of endometriosis cases.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text ⓘ

This paper reports a single case of diaphragmatic endometriosis diagnosed using laparoscopic surgery. A 45-year-old woman evaluated for a suspected right ovarian tumor had enhanced CT incidentally show nodular lesions in the right diaphragm and left pelvis suggestive of malignant dissemination, and PET demonstrated slightly abnormal FDG uptake. Laparoscopic biopsy was performed; intraoperative findings led to partial resection of a diaphragmatic mass, and histopathology with immunohistochemistry supported endometriosis without malignant transformation. The authors note that preoperative diagnosis is difficult because diaphragmatic endometriosis lacks specific radiologic features. This paper is centrally about endometriosis—specifically diaphragmatic endometriosis diagnosed by laparoscopic biopsy and histopathologic confirmation.

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Abstract

Endometriosis is a benign gynecological disorder characterized by the implantation of ectopic endometrial tissue outside the uterine cavity. Endometriotic lesions are commonly found in the pelvic cavity. Extra-pelvic endometriosis occurs much less frequently, and diaphragmatic endometriosis is estimated to affect 0.19-1.5% of all endometriosis cases.
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症例報告 腹腔鏡下生検が確定診断に有用であった横隔膜内膜症の一例 2025 年 41 巻 2 号 p. 99-104 詳細 抄録 Endometriosis is a benign gynecological disorder characterized by the implantation of ectopic endometrial tissue outside the uterine cavity. Endometriotic lesions are commonly found in the pelvic cavity. Extra-pelvic endometriosis occurs much less frequently, and diaphragmatic endometriosis is estimated to affect 0.19-1.5% of all endometriosis cases. We present a case of diaphragmatic endometriosis diagnosed by laparoscopic surgery. A 45-year-old woman was referred to our hospital for the investigation of a right ovarian tumor. Enhanced computed tomography incidentally revealed nodular lesions in the right diaphragm and left pelvis, which suggested malignant dissemination. Positron emission tomography showed slightly abnormal fluorine-18-deoxyglucose accumulation. A surgical biopsy was required to confirm the diagnosis, and laparoscopic surgery was performed. Intraoperative findings suggested endometriosis, and a diaphragmatic mass was partially resected. Histopathological and immunohistochemical findings were consistent with endometriosis without malignant transformation. It is quite difficult to make a preoperative diagnosis of diaphragmatic endometriosis due to the lack of specific radiological characteristics. This case highlights the importance of considering endometriosis in the differential diagnoses when a diaphragmatic lesion is found, and the efficacy of laparoscopic biopsy to confirm the diagnosis. © 2025 日本産科婦人科内視鏡学会

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endometriosisthoracic_endometriosis

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