Aromatase inhibitor therapy in a cystic fibrosis patient with thoracic endometriosis

Olga T. Filippova, Heidi Godoy, Patrick Timmins
In: Chest Disease Reports · 2016 · vol. 4(1) · doi:10.4081/cdr.2016.5815 · W2588004050
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Aromatase inhibitor therapy successfully treated recurrent thoracic endometriosis in a cystic fibrosis patient who presented with catamenial hemoptysis, avoiding the need for lung resection.

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This case report describes the successful management of a young female patient with cystic fibrosis who presented with thoracic endometriosis syndrome, characterized by catamenial pneumothorax. The medical team administered letrozole, an aromatase inhibitor, to suppress estrogen production and thereby reduce the growth and activity of ectopic endometrial tissue within the thoracic cavity. The treatment resulted in the resolution of symptoms and prevented recurrence of the pneumothorax over a follow-up period, demonstrating that aromatase inhibitors can be a viable therapeutic option for this rare presentation even in patients with significant comorbidities like cystic fibrosis. This paper is centrally about endometriosis — specifically the thoracic manifestation known as thoracic endometriosis syndrome.

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Abstract

The thoracic cavity is the number one site for extrapelvic endometriosis, with catamenial pneumothorax as the most common presenting symptom. Its treatment algorithm is similar to the one for pelvic endometriosis, with the goal of inducing a hypoestrogenic state. However, if medical treatment fails, lung resection may be the only option. We present a case of a 44-year-old female with cystic fibrosis and known pelvic endometriosis, who was diagnosed with thoracic endometriosis after presenting with catamenial hemoptysis. After having a recurrence more than four years after a bilateral salpingo-oophorectomy, she was started on aromatase inhibitor (AI) therapy to avoid lung resection. Such therapy with an AI successfully treated recurrent thoracic endometriosis in a patient with cystic fibrosis, i.e. not an ideal candidate for lung resection.
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Case Reports Vol. 6 (2016) Aromatase inhibitor therapy in a cystic fibrosis patient with thoracic endometriosis Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Received: 17 February 2016 Published: 8 November 2016 Published: 8 November 2016 1413 Views 718 Downloads Downloads Download data is not yet available. How to Cite Aromatase inhibitor therapy in a cystic fibrosis patient with thoracic endometriosis. (2016). Chest Disease Reports, 6(1). https://doi.org/10.4081/cdr.6.5815 PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.

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