Thoracic endometriosis-related non-catamenial pneumothorax with peculiar histological findings

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This case report describes thoracic endometriosis-related non-catamenial pneumothorax with unusual histological findings that might explain some misdiagnosed cases.

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This paper reports a single case of thoracic endometriosis-related non-catamenial pneumothorax with recurrent right pneumothorax that was surgically treated three times, with misdiagnosis during the first two interventions. At the third operation, unusual histological findings on diaphragmatic and pulmonary specimens were identified, which the authors state could partially explain complicated misdiagnosed cases. The authors note that hormonal therapy and/or talc pleurodesis were not sufficient for successful management in this context and emphasize that videothoracoscopic resection has a central role, while also stating that more research is needed on pathogenesis and the influence of hormonal balance. This paper is centrally about endometriosis — it describes thoracic endometriosis-related non-catamenial pneumothorax and the histological findings associated with misdiagnosis.

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Abstract

Thoracic endometriosis-related non-catamenial pneumothorax is a rare entity whose pathogenesis is still less unclear than catamenial pneumothorax one. Hormonal therapy and/or talc pleurodesis are not sufficient for successful management. Surgical videothoracoscopic resection has a central role in the treatment. We displace a case of thoracic endometriosis-related non-catamenial pneumothorax presenting with recurrent right pneumothorax, surgically treated three times and misdiagnosed at first two interventions. At third operation, unusual histological findings on diaphragmatic and pulmonary specimens were disclosed. These results could partially clarify the presentation of some complicated misdiagnosed cases. More has to be investigated about pathogenesis of the disease and influence of the hormonal balance on it. Similar content being viewed by others

References

Fournel L, Bobbio A, Robin E, et al. Clinical presentation and treatment of catameinal pneumothorax and endometriosis-related pneumothorax. Expert Rev Respir Med. 2018;20:1–6. Bobbio A, Dechartres A, Bouam S, et al. Epidemiology of spontaneous pneumothorax: gender-related differences. Thorax. 2015;70:653–8. Alifano M, Jablonski C, Kadiri H, et al. Catamenial and noncatamenial, endometriosis-related or nonendometriosis-related pneumothorax referred for surgery. Am. J. Respir. Crit. Care Med. 2007;176:1048–53. Fukuoka M, Kurihara M, Haga T, et al. Clinical characteristics of catamenial and non-catamenial thoracic endometriosis-related pneumothorax. Respirology. 2015;20(8):1272–6. Haga T, Kataoka H, Otsuji M, et al. Thoracic endometriosis-related pneumothorax distinguished from primary spontaneous pneumothorax in females. Lung. 2014;192:583–7. Bagan P, Barthes FL, Assouad J, et al. Catamenial pneumothorax: retrospective study of surgical treatment. Ann Thorac Surg. 2003;75:378–81. Rossi NP, Goplerud CP. Recurrent catamenial pneumothorax. Arch Surg. 1974;109:173–6. Lillington GA, Mitchell SP, Wood GA. Catamenial pneumothorax. JAMA. 1972;219:1328–32. Legras A, Mansuet-Lupo A, Rousset-Jabolonski C, et al. Pneumothorax in women of child-bearing age: an update classification based on clinical and pathologic findings. Chest. 2014;145:354–60. Sumathi VP, McCluggage WG. CD10 is useful in demonstrating endometrial stroma at ectopic sites and in confirming a diagnosis of endometriosis. J Clin Pathol. 2002;55(5):391–2. Kawaguchi Y, Hanaoka J, Oshio Y, et al. Diagnosis of thoracic endometriosis with immunohistochemistry. J Thorac Dis. 2018;10(6):3468–72. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest The authors declare that they have no conflict of interest. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Scarnecchia, E., Inzirillo, F., Declich, P. et al. Thoracic endometriosis-related non-catamenial pneumothorax with peculiar histological findings. Gen Thorac Cardiovasc Surg 68, 1040–1042 (2020). https://doi.org/10.1007/s11748-019-01184-6 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s11748-019-01184-6

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Condition tags

endometriosisthoracic_endometriosis

MeSH descriptors

Endometriosis Lung Pneumothorax Thoracic Diseases Thoracic Surgery, Video-Assisted Biopsy Diagnostic Errors Endometriosis Endometriosis Endometriosis Female Humans Lung Middle Aged Pneumothorax Pneumothorax Pneumothorax Recurrence Thoracic Diseases Thoracic Diseases

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