Division of Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, The University of Texas, 1515 Holcombe Boulevard, Unit 445, Houston, TX 77030-4009, USA.
Thorac Surg Clin. 2009 Nov;19(4):521-9. doi: 10.1016/j.thorsurg.2009.08.007.
Primary tumors of the diaphragm are rare. The most common benign cystic lesions of the diaphragm are bronchogenic or mesothelial cysts, while the most common benign solid lesion is a lipoma. Benign tumors of the diaphragm are resected if they are symptomatic or if there is a doubt about the diagnosis. The most common primary malignant lesion is rhabdomyosarcoma. Malignant tumors are treated based on histology and often with chemotherapy and/or radiation along with surgical resection if feasible. Endometriosis, a benign process that metastasizes to the diaphragm, is typically treated medically; surgical ablation or resection is considered only after failed conservative treatment. Surgical resection of metastatic malignant tumors, such as ovarian cancer and thymoma, as well as malignancies affecting the diaphragm by direct extension, such as mesothelioma, lung, and esophageal cancer, may provide some survival advantage.
膈的原发性肿瘤较为罕见。膈最常见的良性囊性病变是支气管源性或间皮囊肿，而最常见的良性实体病变是脂肪瘤。如果有症状或对诊断有疑问，则切除膈良性肿瘤。膈最常见的原发性恶性病变是横纹肌肉瘤。恶性肿瘤根据组织学进行治疗，通常采用化疗和/或放疗，如有可能还进行手术切除。子宫内膜异位症是一种良性转移至膈的疾病，通常采用药物治疗；仅在保守治疗失败后才考虑手术消融或切除。膈转移恶性肿瘤（如卵巢癌和胸腺瘤）以及直接侵犯膈的恶性肿瘤（如间皮瘤、肺癌和食管癌）的手术切除可能会带来一定的生存优势。
