Thoracic and diaphragmatic endometriosis: Single-institution experience using novel, broadened diagnostic criteria

Demetrio Larraín, Francisco Suárez, Hernán Braun, Javier Chapochnick, Lidia Díaz, Lidia Diaz, Iván Rojas
Journal of the Turkish German Gynecological Association · 2018 · vol. 19(3) , pp. 116–121 · doi:10.4274/jtgga.2018.0035 · PMID:29865779 · PMC6085532 · W2806001679
article OA: gold CC0 ⤵ 21 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective study applied broadened criteria for thoracic endometriosis syndrome to diagnose and manage five patients with pathologically confirmed thoracic/diaphragmatic endometriosis, finding multidisciplinary, minimally invasive surgery effective and safe.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This single-institution retrospective series reviewed consecutive women with pathology-confirmed thoracic/diaphragmatic endometriosis managed between 2010 and 2017, using an “extended” Thoracic Endometriosis Syndrome (TES) definition that added endometriosis-related diaphragmatic hernia, catamenial chest pain, and endometriosis-related pleural effusion beyond the classic TES entities. Across five women, diagnoses were made either after thoracic surgery evaluation (e.g., for catamenial pneumothorax/fever-like menses-associated chest findings) or incidentally during gynecologic laparoscopy for pelvic endometriosis, and endometriosis was confirmed in all cases. The study reports multidisciplinary minimally invasive surgery (VATS and/or laparoscopy with partial diaphragmatic resection or repair) with follow-up in which all patients remained asymptomatic, while noting that expanded TES criteria could increase incidence but that the evidence is limited by the small case series and retrospective design. This paper is centrally about endometriosis — specifically thoracic and diaphragmatic endometriosis using broadened TES criteria, with some cases arising from known pelvic endometriosis, which is relevant to endometriosis (and not adenomyosis) though the paper does not discuss adenomyosis.

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Abstract

Objective: To describe our experience with the multidisciplinary management of both thoracic/diaphragmatic endometriosis (TED), applying a broadened definition of the “Thoracic endometriosis syndrome (TES)” to define cases. Material and Methods: We present a retrospective series of consecutive patients affected by pathology-proven TED, treated at our institution, during a period of 7 years. Results: Five women were included. Two patients were referred due to catamenial chest/shoulder pain, one due to recurrent catamenial pneumothorax, and one due to new-onset diaphragmatic hernia. One patient had no thoracic symptoms, but diaphragmatic endometriosis was found during gynecologic laparoscopy for pelvic endometriosis. Endometriosis was histologically confirmed in all cases. After follow-up, all patients remain asymptomatic. Conclusion: Broadened TES criteria could increase the incidence of TED and determine better knowledge of this condition. Multidisciplinary, minimally invasive surgery is effective and safe, but should be reserved for tertiary referral centers.

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endometriosisthoracic_endometriosis

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