[Right-sided delayed traumatic diaphragmatic hernia misdiagnosed as a thoracic mass: a case report]

A 69-year-old female presented with persistent wheezing for more than six months, which worsened with cough over the past week. External chest CT showed right-sided pleural effusion and a large soft-tissue mass in the right thorax. With a history of breast cancer, she was initially suspected of having a malignant intrathoracic tumor. On admission, thoracentesis with drainage and PET-CT were performed, yielding no conclusive evidence of malignancy. CT-guided percutaneous biopsy of the mass revealed hepatic tissue pathologically. In view of her previous traffic accident, upper abdominal MRI and diaphragmatic ultrasound were performed, confirming a diagnosis of right-sided traumatic diaphragmatic hernia. The patient was referred to the Thoracic Surgery Department. This case report intends to deepen respiratory physicians'knowledge of traumatic diaphragmatic hernia, improve diagnostic and therapeutic protocols, and reduce missed diagnoses and misdiagnoses.