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Bilateral thoracic endometriosis affecting the lung and diaphragm
Camran Nezhat1, Louise P King, Chandhana Paka
1Center for Minimally Invasive and Robotic Surgery, Stanford University Medical Center Departments of Obstetrics and Gynecology and Surgery, Palo Alto, CA, USA. cnezhat@stanford.edu
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|August 22, 2012
Summary
This study reports the first case of pathologically confirmed bilateral pulmonary parenchymal endometriosis. This rare condition presented as bilateral catamenial pneumothoraces, highlighting a unique manifestation of thoracic endometriosis.
Area of Science:
- Gynecology
- Thoracic Surgery
- Pathology
Background:
- Endometriosis involving the lung and diaphragm is exceptionally rare.
- Thoracic endometriosis commonly presents as catamenial pneumothorax, but bilateral cases are seldom reported.
- Pulmonary parenchymal endometriosis has not been previously documented with pathological confirmation.
Observation:
- A 43-year-old patient with stage IV endometriosis experienced recurrent bilateral pneumothoraces.
- Diagnostic evaluation included video-assisted thoracoscopy, revealing endometriosis implants.
- Surgical intervention involved resection and fulguration of bilateral lung and diaphragmatic endometrial lesions.
Findings:
- Pathological examination confirmed endometrial implants within the lung parenchyma bilaterally.
- This represents the first documented case of pathologically proven bilateral pulmonary parenchymal endometriosis.
- The diaphragmatic implants were also confirmed pathologically.
Implications:
- This case expands the known spectrum of thoracic endometriosis presentations.
- It underscores the importance of considering endometriosis in the differential diagnosis of recurrent bilateral pneumothoraces.
- Further research into the pathogenesis and management of pulmonary parenchymal endometriosis is warranted.
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