Introduction/Background Diaphragmatic involvement in secondary peritoneal carcinomatosis from ovarian cancer presents a diagnostic and therapeutic challenge crucial for ensuring optimal cytoreduction and enhancing patient survival.

Methodology Through this video communication, we aim to emphasise the diagnostic role of diffusion MRI, especially in assessing peritoneal disease, particularly at the diaphragmatic dome. Additionally, we seek to intricately demonstrate the surgical approach to this disease location, showcasing step-by-step complete diaphragmatic peritonectomy with pleural opening and subsequent repair.

Results Multiple MRI sequences will illustrate disease manifestation at the diaphragmatic domes and its comprehensive surgical management, achieving complete excision of all visible disease.

Conclusion Managing peritoneal carcinomatosis, especially the diaphragmatic involvement, presents a significant surgical challenge. MRI serves as a pivotal tool, enabling accurate surgical planning and optimizing surgical outcomes for our patients.

Disclosures .