Thoracic endometriosis syndrome in Nigeria: a single-centre experience

N Ezemba, Ndubueze Ezemba, Okechukwu C Okafor, Okechukwu Charles Okafor, Nwadinma U Emeruem, Charles Adiri, Charles O Adiri
Interactive cardiovascular and thoracic surgery · 2020 · vol. 32(2) , pp. 256–262 · doi:10.1093/icvts/ivaa249 · PMID:33236053 · W3108939612
article OA: bronze CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study analyzed 23 Nigerian patients with thoracic endometriosis syndrome, finding that severe dysmenorrhea and massive hemothorax with ascites were common, often misdiagnosed as tuberculosis, and required multidisciplinary treatment.

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Abstract

OBJECTIVES: Thoracic endometriosis syndrome (TES) is the presence of functional endometrial tissue in or around the lung. There seem to be differences in the clinical presentation of this condition among Nigerian patients. We aim to study the clinical presentation and management outcome of TES in our centre. METHODS: This is an analysis of consecutive patients with TES treated over a 5-year period and followed up for 6 months to 5 years. Information collected included the gynaecological history, clinical presentation, causes of misdiagnosis, modalities of treatment and outcome. RESULTS: Twenty-three patients with TES aged between 24 and 45 years (median 32 years) were treated. Severe dysmenorrhoea was a prominent symptom in 91.3% of cases (median dysmenorrhoea score 8) and was uninfluenced by the marital status (P = 0.522). The patients usually presented with massive or recurrent haemothorax associated with massive ascites [16/23 (69.5%) of cases (P = 0.0006)]. The right side alone was involved in 21 cases and 1 patient had catamenial haemoptysis as a part of her symptoms, even though there was bronchial bleed at bronchoscopy in 6 patients. In 40%, tuberculosis was the misdiagnosis. Diagnosis was established histologically in 18/23 (78.3%) of the cases. Treatment was multimodal and multidisciplinary with notable macroscopic lesions in 77.8% of the patients that had surgery. CONCLUSIONS: TES is not an uncommon lesion. Presentation with massive haemothorax is usually associated with massive ascites. A large percentage of such have pleural and diaphragmatic lesions that require surgical treatment. The ascites may be refractory to treatment requiring repeated paracentesis.

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Condition tags

mesh:D004715endometriosisthoracic_endometriosisdysmenorrhea

MeSH descriptors

Endometriosis Endometriosis Hemothorax Pneumothorax Thoracic Diseases Thoracic Diseases Adult Diaphragm Endometriosis Female Hemothorax Humans Lung Lung Middle Aged Nigeria Pleura Pleura Pneumothorax Pneumothorax

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