Thoracic endometriosis syndrome, not so rare; report of 3 cases -

Ekpe EE, Bassey Ea, Umanah In
In: Case Study and Case Report · 2013 · vol. 3(2) , pp. 95–102 · W1566909518
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This paper reports three cases of thoracic endometriosis syndrome presenting as catamenial pneumothorax or hemothorax, diagnosed clinically and treated with various thoracic interventions and hormonal therapy.

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Abstract

Endometriosis is presence of functional endometrial glands and stroma outside the uterine cavity. It is usually confined to the pelvis, and therefore thoracic endometriosis syndrome (TES) is regarded as a rare disorder characterized by the presence of functioning endometrial tissue in the pleura, the lung parenchyma and/or the airways. TES may therefore present with catamenial hemoptysis, due to the shedding of endometrial tissue in the bronchial tree, or catamenial pneumothorax or hemothorax if the endometrial tissue is localized peripherally. We report our three consecutive patients diagnosed as TES in the first three years of our new cardiothoracic surgery unit. All three patients’ diagnosis was established clinically based on cyclicity of symptoms with temporal relationship with menstrual period in appropriate patients. Patient 1 had left catamenial pneumothorax, patient 2 had right catamenial hemo-pneumothorax and left catamenial hemothorax, while patient 3 had right catamenial hemothorax. Pleural aspirates for cytology and percutaneous pleural biopsies failed to establish the histologic diagnosis. Treatment consisted of closed tube thoracostomy drainage, analgesic, prophylactic antibiotic, chest physiotherapy, whole blood transfusion in two patients, and chemical pleurodesis using either tetracycline or cyclophosphamide injection. Failure of pleurodesis in one pleural space necessitated hormonal therapy with goserelin injection. We advise a high index of suspicion which may enable case findings to disprove the ‘rarity’ of TES.

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endometriosisthoracic_endometriosis

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