Thoracic Endometriosis Syndrome Other Than Pneumothorax: Clinical and Pathological Findings

Bobbio A, Antonio Bobbio, Emeline Canny, Canny E, Audrey Mansuet Lupo, Audrey Lupo, Audrey Mansuet‐Lupo, Mansuet Lupo A, Filippo Lococo, Legras A, Antoine Legras, Magdeleinat P, Pierre Magdeleinat, Regnard JF, Jean-François Regnard, Jean-François Régnard, Gompel A, Anne Gompel, Diane Damotte, Marco Alifano, Alifano M
The Annals of thoracic surgery · 2017 · vol. 104(6) , pp. 1865–1871 · doi:10.1016/j.athoracsur.2017.06.049 · PMID:29054304 · W2765942555
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This retrospective review of 31 patients with thoracic endometriosis syndrome, excluding pneumothorax, identified three subgroups: catamenial chest pain, diaphragmatic hernia, and pleural effusion, all responsive to surgical intervention.

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Abstract

BackgroundThoracic endometriosis syndrome refers to a broad spectrum of clinical manifestations related to the presence of ectopic intrathoracic endometrial tissue. Few studies have reported on manifestations other than pneumothorax.MethodsClinical, surgical, and pathology records of all consecutive women of reproductive age referred to our institution from September 2001 to August 2016 for clinically suspected thoracic endometriosis syndrome were retrospectively reviewed. After excluding women with pneumothorax, we enrolled 31 patients, divided into three subgroups: catamenial chest pain (n = 20), endometriosis-related diaphragmatic hernia (n = 6), and endometriosis-related pleural effusion (n = 5).ResultsSurgery was performed in 11 patients with catamenial thoracic pain (median age, 30 years; range, 23 to 42). Median pain intensity assessed on the 0 to 10 Visual Analogue Scale was 8 (range, 8 to 9) before surgery. At surgery, 8 patients had diaphragmatic endometriosis implants, which were resected with direct suture of diaphragm. At follow-up, median pain score was 3 (range, 0 to 8). In the group presenting with diaphragmatic hernia (median age, 36 years; range, 29 to 50), diaphragm was repaired by direct suture or placement of prosthesis in 4 and 2 cases, respectively. At follow-up, no sign of recurrent hernia was observed. Finally, among women with endometriosis-related pleural effusion (median age, 30 years; range, 25 to 42), surgical treatment was represented by evacuation of the pleural effusion and biopsy (n = 4) or removal (n = 1) of visible endometrial foci.ConclusionsThoracic endometriosis syndrome is a poorly recognized entity responsible for various manifestations other than pneumothorax. In case of catamenial thoracic pain, diaphragmatic hernia and catamenial pleural effusion surgery should be advised in a multidisciplinary setting.

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Condition tags

endometriosisthoracic_endometriosis

MeSH descriptors

Chest Pain Endometriosis Hernia, Hiatal Pleural Effusion Adult Chest Pain Chest Pain Endometriosis Endometriosis Endometriosis Female Hernia, Hiatal Hernia, Hiatal Humans Pleural Effusion Pleural Effusion Retrospective Studies Syndrome Young Adult

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