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[Thoracic endometriosis].

H Coimbra1, E C Brancho, F Falcão

  • 1Serviço de Ginecologia, Hospitais da Universidade de Coimbra.

Acta Medica Portuguesa
|October 12, 2000
PubMed
Summary
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This case study highlights diaphragmatic endometriosis causing recurrent catamenial pneumothorax. Surgical intervention and hormone therapy resolved the condition in a 45-year-old woman.

Area of Science:

  • Gynecology
  • Thoracic Surgery
  • Medical Imaging

Background:

  • Endometriosis, a condition where uterine tissue grows outside the uterus, presents diagnostic challenges, especially in extra-genital locations.
  • Catamenial pneumothorax, a rare form of spontaneous pneumothorax, is associated with the menstrual cycle.

Observation:

  • A 45-year-old woman experienced recurrent right-sided catamenial pneumothorax.
  • Imaging revealed a transdiaphragmatic hernia with hepatic content alongside the pneumothorax.
  • Diagnostic and therapeutic thoracotomy confirmed diaphragmatic endometriosis.

Findings:

  • Diaphragmatic endometriosis was identified as the cause of the recurrent pneumothorax and associated hernia.
  • Surgical management included thoracotomy, total hysterectomy, and bilateral salpingo-oophorectomy.

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  • Combined hormone therapy was initiated post-operatively.

    • Implications:

    • This case underscores the importance of considering endometriosis in atypical presentations like catamenial pneumothorax with diaphragmatic involvement.
    • Successful management involves a multidisciplinary approach combining surgical resection and hormonal suppression.
    • Further research into the pathogenesis of extra-genital endometriosis is warranted.