title: Spontaneous diaphragmatic rupture related to local invasion by retroperitoneal liposarcoma.
abstract: We report a case of the female patient who was admitted to the hospital because of syncope experienced while climbing stairs. Diagnostic workup raised the suspicion of a right diaphragmatic rupture that was eventually confirmed by surgery (right-sided thoracotomy). Surgery also revealed  tissue protruding through the rupture site from within the retroperitoneum that was proven subsequently to be a dedifferentiated liposarcoma. Second surgery was performed to completely remove the liposarcoma tissue and repair a coincident old right lumbar region hernia. The patient recovered  fully. Spontaneous rupture of the diaphragm is rare and this is especially true for the right hemidiaphragm. We report the first case of diaphragmatic rupture caused by local infiltration by a retroperitoneal liposarcoma. This and similar reports emphasise that in cases with high clinical  suspicion of diaphragmatic rupture, diagnosis should be pursued even in the absence of a preceding traumatic event.
authors.affiliation: University Hospital Mostar, Mostar, Bosnia and Herzegovina.
authors.forename: M
authors.initials: M
authors.lastname: Pehar
authors.forename: I
authors.initials: I
authors.lastname: Vukoja
authors.forename: D
authors.initials: D
authors.lastname: Rozić
authors.forename: J
authors.initials: J
authors.lastname: Mišković
mesh_terms: D003964:Diaphragm; D005260:Female; D006801:Humans; D008080:Liposarcoma / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D009135:Muscular Diseases / Q000209:etiology*; D009361:Neoplasm Invasiveness / Q000473:pathology; D012186:Retroperitoneal Neoplasms / Q000150:complications* / Q000473:pathology; D012422:Rupture, Spontaneous / Q000209:etiology