Thoracic Endometriosis Syndrome Other Than Pneumothorax: Clinical and Pathological Findings

Thoracic endometriosis syndrome refers to a broad spectrum of clinical manifestations related to the presence of ectopic intrathoracic endometrial tissue. Few studies have reported on manifestations other than pneumothorax. Clinical, surgical, and pathology records of all consecutive women of reprod...

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Bibliographic Details
Published in:	The Annals of thoracic surgery Vol. 104; no. 6; pp. 1865 - 1871
Main Authors:	Bobbio, Antonio, Canny, Emeline, Mansuet Lupo, Audrey, Lococo, Filippo, Legras, Antoine, Magdeleinat, Pierre, Regnard, Jean-François, Gompel, Anne, Damotte, Diane, Alifano, Marco
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Inc 01-12-2017
Subjects:	Adult Chest Pain - etiology Chest Pain - pathology Endometriosis - diagnostic imaging Endometriosis - pathology Endometriosis - therapy Female Hernia, Hiatal - etiology Hernia, Hiatal - pathology Humans Pleural Effusion - etiology Pleural Effusion - pathology Retrospective Studies Syndrome Young Adult
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Summary:	Thoracic endometriosis syndrome refers to a broad spectrum of clinical manifestations related to the presence of ectopic intrathoracic endometrial tissue. Few studies have reported on manifestations other than pneumothorax. Clinical, surgical, and pathology records of all consecutive women of reproductive age referred to our institution from September 2001 to August 2016 for clinically suspected thoracic endometriosis syndrome were retrospectively reviewed. After excluding women with pneumothorax, we enrolled 31 patients, divided into three subgroups: catamenial chest pain (n = 20), endometriosis-related diaphragmatic hernia (n = 6), and endometriosis-related pleural effusion (n = 5). Surgery was performed in 11 patients with catamenial thoracic pain (median age, 30 years; range, 23 to 42). Median pain intensity assessed on the 0 to 10 Visual Analogue Scale was 8 (range, 8 to 9) before surgery. At surgery, 8 patients had diaphragmatic endometriosis implants, which were resected with direct suture of diaphragm. At follow-up, median pain score was 3 (range, 0 to 8). In the group presenting with diaphragmatic hernia (median age, 36 years; range, 29 to 50), diaphragm was repaired by direct suture or placement of prosthesis in 4 and 2 cases, respectively. At follow-up, no sign of recurrent hernia was observed. Finally, among women with endometriosis-related pleural effusion (median age, 30 years; range, 25 to 42), surgical treatment was represented by evacuation of the pleural effusion and biopsy (n = 4) or removal (n = 1) of visible endometrial foci. Thoracic endometriosis syndrome is a poorly recognized entity responsible for various manifestations other than pneumothorax. In case of catamenial thoracic pain, diaphragmatic hernia and catamenial pleural effusion surgery should be advised in a multidisciplinary setting.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-4975 1552-6259
DOI:	10.1016/j.athoracsur.2017.06.049