60% of diaphragm cancers are malignant; 40% benign.
Benign tumours include fibroma, lipoma, mesothelioma, angiofibroma, and neurogenic tumours. Also, there may be congenital cysts.
Malignant tumours are mostly metastatic, commonly from neighbouring structures such as the oesophagus, lung, liver, and colon. Also, retroperitoneal tumours may extend into the diaphragm. Primary malignancies include fibrosarcoma and neurofibrosarcomas.
Many of these neoplasms produce few symptoms and are diagnosed by radiography or CT scan.
Benign types are managed by simple excision. Malignancy requires wide removal. Radiotherapy and chemotherapy are rarely indicated.
Last reviewed 01/2018