Accessory diaphragm associated with pulmonary metastasis from cervical cancer

In accessory diaphragm, a rare congenital anomaly, the hemithorax is divided into two compartments by a fibromuscular membrane. Herein, we report the case of a 34-year-old woman with an accessory diaphragm who underwent two lung resections for suspected lung metastasis following surgery for cervical cancer 3 years ago. She was asymptomatic; no pulmonary infection history. Computed tomography revealed well-defined solid nodule in the right upper lobe dorsal segment and accessory diaphragm. The pulmonary vessels and bronchus were abnormally distributed through the accessory diaphragm hiatus with no lung infection signs or adhesions upon thoracoscopy. Subsequently, dorsal segmentectomy was performed. She developed lung metastasis 2.5 years later, undergoing a second lung resection. Due to no lung adhesions, the remaining accessory diaphragm was removed owing to visual field obstruction. Accessory diaphragm associated with lung malignancies need not be removed but opened. However, it may be removed if it hindered the visual field.