Case reportIntradiaphragmatic pulmonary sequestration: advantages of the thoracoscopic approach
Section snippets
Case 1
A 7-week-old female infant was referred for evaluation of a left-sided peridiaphragmatic lesion detected on prenatal ultrasound. Pregnancy and delivery were otherwise unremarkable. Postnatal ultrasounds could not definitively localize the mass relative to the diaphragm. A computed tomographic (CT) scan showed a 2.0 × 1.1 × 1.8 cm soft tissue mass separate from the paraspinal region and adrenal gland (Fig. 1A). No feeding or draining vessels could be identified. A review of all the diagnostic
Case 2
A 4-week-old male infant was referred for evaluation of a left lower lobe cystic pulmonary mass detected on prenatal ultrasound. Pregnancy and delivery were unremarkable. A CT scan showed a soft tissue mass in the left posterior costophrenic sulcus measuring 2.3 × 2.0 × 1.7 cm (Fig. 1B). No feeding or draining vessels were identified, and the location of the lesion relative to the diaphragm could not be determined. A subsequent ultrasound showed the mass to be separated from the adrenal gland
Discussion
Pulmonary sequestration is a focus of nonfunctioning lung parenchyma that develops apart from the normal tracheobronchial tree. These anomalies account for up to 6% of congenital pulmonary malformations. Sequestrations are classified as ILS or ELS depending upon whether they are invested in the same visceral pleura as the adjacent normal lung [1]. Approximately 25% of sequestrations are ELS, with up to 15% of these occurring below the diaphragm. Identification of a sequestration is generally
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Cited by (16)
Revising the classification of lung sequestrations
2021, Clinical ImagingCitation Excerpt :In the last decades, the increasing detection of congenital lung lesions in utero has increased both the number of postnatal imaging exams and of surgical resections in pediatric patients. The obtained data evidence a wide variability in the anatomical structures involved in lung sequestrations: pleura, arterial supply and venous drainage, airways and lung parenchyma [10–16]. The aims of this article are to identify the atypical anatomical findings detected on imaging studies, during surgery and at pathology in a series of children with confirmed lung sequestrations and to quantify their frequency.
Diagnosis and management of intradiaphragmatic extralobar pulmonary sequestration: A report of 11 cases
2015, Journal of Pediatric SurgeryCitation Excerpt :In the 11 patients included in this study, we used three surgical methods. In our surgical cases, we found that the best path for removal of the mass was accessing it from the chest, as McAteer [11] and Nijagal A [12] have previously reported. Transthoracic surgery, despite the need to cut the diaphragm to remove the tissue mass from the diaphragm and the pleural space, is a clean surgical procedure that decreases the amount of bleeding.
Benign vascular malformation of the diaphragm
2014, Journal of Pediatric Surgery Case ReportsCitation Excerpt :Diaphragmatic masses are rare, represented in the literature by case reports and small series. The differential diagnosis include congenital bronchopulmonary malformations such as pulmonary sequestration [1] and bronchogenic cysts [2,3], vascular malformations such as hemangiomas [4] as well as malignancies of predominantly mesenchymal origin (inflammatory myofibroblastoma [5], solitary fibrous tumors of the pleura [6], rhabdomyosarcoma [7]). In the largest review of the literature, Cada et al. identified fewer than 200 cases over approximately 140 years, of which, 78% were malignant [8].
Intradiaphragmatic extralobar pulmonary sequestration
2014, Anales de PediatriaThe complexities in diagnosing intradiaphragmatic extrapulmonary sequestration: a case report
2023, Annals of Pediatric SurgeryIntradiaphragmatic pulmonary sequestrations: a surgical challenge. Case series
2023, Frontiers in Surgery