A case report of thoracic endometriosis – A rare cause of haemothorax

Pankratjevaitė, Lina; Samiatina-Morkūnienė, Diana

doi:10.1016/j.ijscr.2017.02.052

Cited by 27 publications

(26 citation statements)

References 19 publications

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“…[2][3][4][5][6][7][8] These presentations result from the presence of endometrial tissue on the pleural surfaces (CCP, CPT, CPE, CPM), in the lung parenchyma (pulmonary nodule) or the airway (CHp). Pleural involvement is more common, accounting for about 83% of TES, while parenchymal and airway involvement account for 17%, [9] and our study found a similar distribution. An even rarer occurrence of endometriosis on the thoracic aorta has been reported.…”

Section: Discussionsupporting

confidence: 83%

“…[3,[5][6][7]9,10] It is an uncommon condition, documented in the literature mostly in case reports and case series. [5][6][7][9][10][11][12] An analysis of 110 case reports/series published in English was conducted by Joseph and Sahn in 1996, [13] and Channabasavaiah and Joseph, [4] in 2010, conducted a similar review with the same number of patients, covering a 6.5-year period. Haga et al, [14] in Tokyo, Japan, reported 84 cases of CPT while evaluating 570 cases of spontaneous pneumothorax in women.…”

Section: Discussionmentioning

confidence: 99%

“…Our observation that chemical pleurodesis alone has a poor success rate in patients with CPE is supported by the literature. [9,10,16] This is expected, as continuous activity from cyclical proliferation of endometrial implants, and also migration through patent diaphragmatic defects, predisposes to recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Thoracic endometriosis syndrome at University of Ilorin Teaching Hospital

Adeoye

Adeniran

Adesina

et al. 2018

Afr J Thorac Crit Care Med

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Background. Endometriosis is defined as the presence of endometrial tissue (stroma and functional glands) outside the uterine cavity in women of reproductive age. Ectopic sites are frequently located in the pelvis; extrapelvic sites have been reported in the gastrointestinal tract and thoracic cavity. Thoracic manifestation of endometriosis constitutes thoracic endometriosis syndrome (TES). Objectives. To examine the presentation pattern and outcome of in the management of TES. Methods. This study is a retrospective review of medical records of patients diagnosed with endometriosis at the University of Ilorin Teaching Hospital over a 3.5-year period from January 2014 to June 2017. Results. A total of 21 patients presented with endometriosis, of whom 8 (38.1%) presented with TES. The most common variety of TES was catamenial pleural effusion (CPE) accounting for 75%, followed by catamenial chest pain (37.5%). Two patients (25%) each presented with catamenial pneumothorax and catamenial haemoptysis, while 1 (12.5%) had catamenial surgical emphysema. Closed thoracostomy tube drainage plus chemical pleurodesis was the most frequent intervention technique, accounting for 62.5%. Conclusion. TES remains an uncommon entity, despite being the most common extrapelvic manifestation of endometriosis. CPE appeared to be the most common variant of TES in our environment. Currently available treatment options need to be improved, and more use made of video-assisted thoracoscopic surgery.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Thoracic endometriosis syndrome at University of Ilorin Teaching Hospital

Adeoye

Adeniran

Adesina

et al. 2018

Afr J Thorac Crit Care Med

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“…Medical therapy consists of hormonal suppression of ovarian estrogen secretion that can be achieved with oral contraceptives, progesterone agonists, gonadotropin-releasing hormone agonists, and danazol. A combination of medical and surgical management is associated with low recurrence in a long-term follow-up [8,9,12].…”

Section: Discussionmentioning

confidence: 99%

Multimodality Thoracoabdominal Imaging Findings in a Rare Case of Thoracic Endometriosis Syndrome

Rangunwala

Sitta

Vyas

et al. 2020

Cureus

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Thoracic endometriosis syndrome (TES) is an extremely rare disorder, and it is defined as the presence of functional endometrial tissue in pleura, airways, and lung parenchyma. We describe a rare case of a 29-year-old nulliparous female who presented with abdominal pain, dyspareunia, and shortness of breath. She complained of worsening of symptoms around the menstrual cycle. Initial workup showed markedly elevated CA-125 levels. A chest radiograph and CT of the chest, abdomen, and pelvis demonstrated large tension hydrothorax, ascites, and bilateral ovarian cysts. A chest tube was placed to decompress the tension hydrothorax, which drained copious amounts of blood. In view of the unexplained etiology of large hemothorax and elevated CA-125 levels, an MRI of the abdomen and pelvis was performed. This revealed advanced pelvic endometriosis, a right pleural nodule, and ipsilateral hydropneumothorax. Based on these findings, a diagnosis of TES was presumed. The patient was then referred to video-assisted thoracoscopy (VATS) and continuous estrogen suppression for optimal treatment. On early follow-up, she presented with recurrent hydropneumothorax, which was successfully managed with CT-guided chest tube placement and remained stable on further follow-ups. TES diagnosis is often challenging and delayed, demanding a high index of suspicion in patients with risk factors and characteristic clinical presentation. Radiologists should be aware of key imaging findings to help in early diagnosis for timely clinical and surgical management.

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“…Thoracic endometriosis syndrome (TES) is a rare disease in which a functioning endometrial tissue is observed in the pleura, lung parenchyma, airways, or diaphragm [1][2][3][4]. The clinical manifestations of thoracic endometriosis are catamenial pneumothorax (CP) [5], catamenial hemoptysis (CH), catamenial hemothorax (CHT) [6,7] and lung nodules [8]. Thoracic endometriosis dates back to as early as 1912 when the first case was documented [9].…”

Section: Introductionmentioning

confidence: 99%

Thoracic Endometriosis presented as catamental hemoptysis: Fourteen Cases of a Rare Disease and the hormonal treatment management

Dai

Liu

et al. 2020

Preprint

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Background: Thoracic endometriosis syndrome (TES) is a rare disease in which a functioning endometrial tissue is observed in the pleura, lung parenchyma, airways, or diaphragm. The optimal management of this disease remains a matter of debate Methods: Retrospective study in one university based tertiary care hospital between 1997 to 2017. 14 women presented as CH diagnosed with thoracic endometriosis were included. The main outcome of measure was cessation or recurrence of the clinical manifestations of thoracic endometriosis. Baseline parameters were presented using descriptive statistics. For categorical variables, Pearson’s chi-square tests or Fisher’s exact tests was used as appropriate to describe the characteristic of thoracic endometriosis presented as CH, and the long-term prognosis after hormonal treatment. Results : The mean onset age of the 14 patients was 30.21±5.40 years. Catamenial hemoptysis (CH) was characteristic symptom of these patients, and most of patients (13/14, 92.9%) had regular menstruation and only 42.9% (6/14) of the patients complained of different degrees of dysmenorrhea. All patients underwent chest computed tomography (CT) scan during menstruation and 2 or 3 weeks after menstruation, which showed the obvious shrinking or disappearance of the lesions. No active bleeding on bronchial mucosa were observed in patients with CH, and the bronchoalveolar lavage (BAL) did not find the typical abnormality. All of patients were given GnRH-a for 3 to 6 months, eleven of them were administered with COCs cyclically after GnRH-a. All patients were followed up and the median follow-up duration was 24 months. Hemoptysis recurrence was observed in one patient. Conclusion: CH is a rare clinical entity of thoracic endometriosis, which has the typical cyclic manifestation with menstruation. The change of CT images during and after menstruation or the response to GnRHa were helpful for accurate diagnosis. Hormonal treatment with GnRH-a followed by COCs cyclically could be employed as a choice of therapy for efficient management of thoracic endometriosis.

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A case report of thoracic endometriosis – A rare cause of haemothorax

Cited by 27 publications

References 19 publications

Thoracic endometriosis syndrome at University of Ilorin Teaching Hospital

Thoracic endometriosis syndrome at University of Ilorin Teaching Hospital

Multimodality Thoracoabdominal Imaging Findings in a Rare Case of Thoracic Endometriosis Syndrome

Thoracic Endometriosis presented as catamental hemoptysis: Fourteen Cases of a Rare Disease and the hormonal treatment management

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