Successful diagnosis of an occult fallopian tube carcinoma detected from the diaphragm metastasis

Trans-diaphragmatic Pathologies: Anatomical Background and Spread of Disease on Cross-sectional Imaging

The diaphragm is not only a sheet of muscle separating the abdominal and thoracic cavities: it plays an essential role in ventilation and can act as a gateway for the spread of different disease processes between the abdominal and the thoracic cavity. Careful attention to the appearance of the diaphragm on various imaging modalities is essential to ensure the accurate diagnosis of diaphragmatic disorders, which may be secondary to functional or anatomical derangements.

Anterior mediastinal metastasis of primary fallopian tube adenocarcinoma: a case report

BACKGROUND

Primary fallopian tube carcinoma (PFTC) is a malignant tumor of the female genital tract that mostly presents intraperitoneal dissemination in clinical practice. The incidence of upper anterior mediastinal metastasis in PFTCs is extremely rare. We herein report a rare case of PFTC mediastinal metastasis after radical resection. When anterior mediastinal metastasis of an unknown origin is encountered, the possibility of PFTC should be considered.

CASE PRESENTATION

A 68-year-old female who was previously diagnosed with PFTC after radical resection of a primary tumor in the fallopian tube was admitted to our department with a right anterior mediastinum mass. Radical resection of the mediastinal mass was performed, and poorly differentiated metastatic adenocarcinoma of the fallopian tube was confirmed. There was no recurrence in the 24 months after the curative operation.

CONCLUSION

To our knowledge, no mediastinal metastasis of PFTC has been reported yet. Thus, we presented this rare case indicating the heterogeneity of this malignant disease and to draw attention to the occasional distant metastasis of PFTC in clinical practice.

Isolated Diaphragmatic Metastasis Originating From Early Endometrial Cancer

Metastatic diaphragm tumors are rare. We herein describe an extremely rare case of isolated diaphragmatic metastasis from an endometrial cancer. A 47-year-old asymptomatic woman, who had previously undergone surgical resection for stage IA endometrial cancer with high uptake of fluorodeoxyglucose, presented with a diaphragmatic tumor. The resected diaphragmatic specimen revealed adenocarcinoma within the diaphragm, which was similar to the previous endometrial cancer. The tumor was eventually diagnosed as a diaphragmatic metastasis from endometrioid adenocarcinoma of uterus. Diaphragmatic metastasis should be considered in the differential diagnosis in patients with previous malignancies that show high fluorodeoxyglucose uptake, even in early-stage primary tumors.