Intra-Diaphragmatic Extralobar Pulmonary Sequestration in an Adult With Laparoscopic Resection

Intra-diaphragmatic extralobar pulmonary sequestration (IDEPS) is a rare congenital anomaly that is exceedingly uncommon in adults. Herein, we report an adult case of incidentally detected IDEPS. Computed tomography revealed a 49-mm mass beneath the left diaphragm with internal calcifications; however, preoperative diagnosis and precise localization were challenging. The differential diagnoses included extralobar pulmonary sequestration, bronchogenic cyst, and other tumors. Diagnostic surgical resection was planned with a laparoscopic approach based on imaging findings. Intra-operatively, the lesion was identified in the left diaphragmatic muscle, supplied by a branch of the left inferior phrenic artery, and was successfully resected laparoscopically, with an uneventful postoperative course. Histopathological examination confirmed the diagnosis of IDEPS. This case underscores the difficulty in the preoperative localization of IDEPS and demonstrates that appropriate planning and multidisciplinary input are crucial for performing safe and effective surgery.