{"paper_id":"362fe9af-ab10-4b68-91ef-68a54a74a8ac","body_text":"This issue of the  AJTCCM  includes a retrospective review by Adeoye\n et al .  [1]  on their experience with thoracic endometriosis syndrome, as\nseen over a 3.5-year period at a teaching hospital in Ilorin, Nigeria.\nThoracic endometriosis syndrome, which refers to the presence\nof endometrial tissue in the lung parenchyma or on the pleural\nsurfaces, is an extremely rare condition. Presentation is variable, but\npatients can be broadly grouped into those who present with signs\nand symptoms related to catamenial pneumothorax, catamenial\nhaemothorax or intrapulmonary (parenchymal or airway) nodules,\nwhich usually present with haemoptysis. In the reported study, pleural\neffusion was the most frequent presenting sign.\nAs with all rare conditions, diagnosis is often delayed. A diagnosis\nis based on a high clinical index of suspicion in the first instance.\nPointers include: a cyclical presentation of chest pain, dyspnoea,\ncough or haemoptysis that occurs in relation to the menstrual cycle,\ncases presenting in women during the productive years and symptoms\nthat affect the right hemithorax. Clinical suspicion should prompt\ninvestigation that involves a computed tomography scan and testing\nCA-125 serum levels.\nThe authors recognise the importance of thoracoscopic techniques\nfor obtaining a histological diagnosis and intrathoracic management\nof the pleural space. They also mention the inadequacy of basing \nthe diagnosis on pleural fluid and bronchial lavage cytology. Their\nobservation that chemical pleurodesis alone has a poor success rate in\npatients with pleural effusions is also supported by the literature. They\nconclude that early thoracoscopic intervention is desirable, and that\npleurectomy should replace pleurodesis when indicated.\nThe authors have provided a concise summary and literature review\nof various aspects of this interesting and complex condition.","source_license":"CC0","license_restricted":false}