scholarly journals Aromatase inhibitor therapy in a cystic fibrosis patient with thoracic endometriosis

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Olga T. Filippova ◽  
Heidi E. Godoy ◽  
Patrick F. Timmins III
Keyword(s):  
Cystic Fibrosis ◽  
Aromatase Inhibitor ◽  
Lung Resection ◽  
Treatment Algorithm ◽  
Pelvic Endometriosis ◽  
Catamenial Pneumothorax ◽  
Catamenial Hemoptysis ◽  
The One ◽  
Extrapelvic Endometriosis ◽  
Thoracic Endometriosis

The thoracic cavity is the number one site for extrapelvic endometriosis, with catamenial pneumothorax as the most common presenting symptom. Its treatment algorithm is similar to the one for pelvic endometriosis, with the goal of inducing a hypoestrogenic state. However, if medical treatment fails, lung resection may be the only option. We present a case of a 44-year-old female with cystic fibrosis and known pelvic endometriosis, who was diagnosed with thoracic endometriosis after presenting with catamenial hemoptysis. After having a recurrence more than four years after a bilateral salpingo-oophorectomy, she was started on aromatase inhibitor (AI) therapy to avoid lung resection. Such therapy with an AI successfully treated recurrent thoracic endometriosis in a patient with cystic fibrosis, i.e. not an ideal candidate for lung resection.

Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treatment

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Thiers Soares ◽  
Marco Aurelio Oliveira ◽  
Karen Panisset ◽  
Nassir Habib ◽  
Sara Rahman ◽  
...  
Keyword(s):  
Multidisciplinary Treatment ◽  
Posterior Part ◽  
Pulmonary Nodules ◽  
Diagnosis And Treatment ◽  
Childbearing Age ◽  
Invasive Approach ◽  
Catamenial Pneumothorax ◽  
Abdominal Approach ◽  
The One ◽  
Thoracic Endometriosis

Abstract Endometriosis of the diaphragm has been gaining more attention in the practice of gynecologists and thoracic surgeons in recent years. Understanding related symptoms and developing imaging methods have improved their approach. A review of the literature was performed with the aim to report on incidence, diagnosis, treatment and prognosis of diaphragmatic endometriosis. We also cover the issue of the Thoracic Endometriosis Syndrome (TES). Complaints of cyclic chest pain in patients of childbearing age should have as differential diagnosis the presence of thoracic endometriosis. Catamenial pneumothorax is the main manifestation of diaphragmatic endometriosis and Thoracic Endometriosis Syndrome. Other possible manifestations are hemothorax, pulmonary nodules, and diaphragmatic hernia. Despite the possibility of drug treatment, many patients will be submitted to surgical treatment. The minimally invasive approach should be the one of choice. The robotic pathway allows for an easier approach due to its ability to articulate robotic arms, allowing the treatment of lesions in hard-to-reach locations, such as the posterior part of the diaphragm. Multidisciplinary treatment should be used in most cases, as only abdominal approach is not sufficient for the diagnosis and treatment of lesions in the thoracic cavity. The approach of endometriosis of the diaphragm and Thoracic Endometriosis Syndrome should be multidisciplinary, allowing the improvement of quality of life in most patients.

scholarly journals Thoracic Endometriosis Syndrome–Uncommon Entity of Pelvic Endometriosis

2017 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Surgical Treatment ◽  
Spontaneous Pneumothorax ◽  
Pulmonary Nodules ◽  
Pelvic Endometriosis ◽  
Catamenial Pneumothorax ◽  
Complex Condition ◽  
Clinical Dilemma ◽  
Thoracic Endometriosis

Thoracic Endometriosis syndrome (TES) is a complex condition consisting of four distinct clinical entities: catamenial pneumothorax, catamenial hemothorax, hemoptysis, and pulmonary nodules. TES poses a clinical dilemma when presented with chest symptoms rather than predictable symptoms of pelvic endometriosis. It is a complex condition often diagnosed late. The treatment includes hormonal management and surgical treatment if needed. We report the case of an 18-year-old girl who was initially diagnosed with recurrent spontaneous pneumothorax and subsequently proved to have catamenial pneumothorax secondary to pelvic endometriosis.

scholarly journals The Importance of Stromal Endometriosis in Thoracic Endometriosis

Cells ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 180
Author(s):  
Ezekiel Mecha ◽  
Roselydiah Makunja ◽  
Jane B. Maoga ◽  
Agnes N. Mwaura ◽  
Muhammad A. Riaz ◽  
...  
Keyword(s):  
Chest Pain ◽  
Recurrence Rate ◽  
Sensitive Detection ◽  
Pelvic Endometriosis ◽  
Rare Type ◽  
Catamenial Pneumothorax ◽  
Diagnosis And Classification ◽  
Thoracic Endometriosis ◽  
Very High

Thoracic endometriosis (TE) is a rare type of endometriosis, where endometrial tissue is found in or around the lungs and is frequent among extra-pelvic endometriosis patients. Catamenial pneumothorax (CP) is the most common form of TE and is characterized by recurrent lung collapses around menstruation. In addition to histology, immunohistochemical evaluation of endometrial implants is used more frequently. In this review, we compared immunohistochemical (CPE) with histological (CPH) characterizations of TE/CP and reevaluated arguments in favor of the implantation theory of Sampson. A summary since the first immunohistochemical description in 1998 until 2019 is provided. The emphasis was on classification of endometrial implants into glands, stroma, and both together. The most remarkable finding is the very high percentage of stromal endometriosis of 52.7% (CPE) compared to 10.2% (CPH). Chest pain, dyspnea, right-sided preference, and diaphragmatic endometrial implants showed the highest percentages in both groups. No significant association was found between the recurrence rate and the various appearances of endometriosis. Sometimes in CPE (6.8%) and CPH (30.6%) no endometrial implants were identified underlining the importance of sensitive detection of endometriosis during and after surgery. We suggest that immunohistochemical evaluation should become mandatory and will improve diagnosis and classification of the disease.

scholarly journals Narrow band imaging for thoracic endometriosis

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takehiro Yamamoto ◽  
Ryo Fujikawa ◽  
Yoshifumi Arai ◽  
Toru Nakamura
Keyword(s):  
Narrow Band ◽  
Narrow Band Imaging ◽  
Thoracoscopic Surgery ◽  
Clinical Manifestations ◽  
Pelvic Endometriosis ◽  
Affected Area ◽  
Case Presentations ◽  
Histological Confirmation ◽  
Extrapelvic Endometriosis ◽  
Thoracic Endometriosis

Abstract Background The thoracic cavity is the most frequent site of extrapelvic endometriosis. It exhibits a wide variety of clinical manifestations, such as chest pain, cough, and respiratory distress, and is frequently associated with pelvic endometriosis. Although histological confirmation is the gold standard for a definitive diagnosis, endoscopic identification of the affected area is often difficult. Narrow band imaging (NBI) is an imaging technique that emphasizes vascular structures and is reported to be useful in the diagnosis of pelvic endometriosis. Case presentations A 31-year-old woman and 39-year-old woman developed a recurrent right pneumothorax during their menstruation cycles. They both had no medical history suggesting pelvic endometriosis. We planned an elective video-assisted thoracoscopic surgery for the suspicion of thoracic endometriosis. In addition to white light alone, an NBI observation enhanced the microvasculature of the suspected lesions and allowed us to identify the affected area more clearly. Partial resections of the diaphragm were performed. Histopathological and immunohistochemical studies of each specimen confirmed the diagnosis of extrapelvic endometriosis. Conclusions NBI may improve the diagnostic accuracy for thoracic endometriosis, especially in clinically suspected patients but without a history of pelvic endometriosis.

scholarly journals Catamenial Hemoptysis and Pneumothoraces in a Patient with Cystic Fibrosis

2007 ◽  
Vol 14 (5) ◽  
pp. 295-297 ◽  
Author(s):  
Chris M Parker ◽  
Robert Nolan ◽  
M Diane Lougheed
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Oral Contraceptive ◽  
Resonance Imaging ◽  
Present Patient ◽  
Thoracic Computed Tomography ◽  
Life Threatening ◽  
Catamenial Hemoptysis ◽  
Thoracic Endometriosis

Hemoptysis or pneumothorax that recurs with the onset of menses is strongly suggestive of thoracic endometriosis syndrome (TES). TES is a rare disorder, with relatively few cases reported in the literature. A 32-year-old woman with cystic fibrosis, who over a period of several months had experienced recurrent catamenial hemoptysis and pneumothoraces, including an episode of life-threatening hemoptysis that coincided with menstruation, is presented. Thoracic computed tomography and magnetic resonance imaging scans, as well as a bronchosopic evaluation that demonstrated endobronchial lesions that disappeared after menses, support the diagnosis of TES in the present patient. The patient was treated empirically with danazol and subsequently underwent a successful double-lung transplantation. Danazol was discontinued postoperatively, and she was started on an oral contraceptive. Eighteen months post-transplant, she has not experienced a recurrence of her catamenial symptoms, despite having resumed a regular menstrual cycle.

scholarly journals Hemoptysis and Endometriosis: An Unusual Association — Case Report and Review of the Literature

2018 ◽  
Vol 40 (05) ◽  
pp. 300-303 ◽  
Author(s):  
Joao Leonardo-Pinto ◽  
Cristina Benetti-Pinto ◽  
Iuri Quagliato ◽  
Daniela Yela
Keyword(s):  
Empirical Therapy ◽  
Rare Condition ◽  
Lung Nodules ◽  
Review Of The Literature ◽  
Deep Endometriosis ◽  
Catamenial Pneumothorax ◽  
Unusual Association ◽  
Catamenial Hemoptysis ◽  
The Right ◽  
Thoracic Endometriosis

AbstractThoracic endometriosis syndrome is a rare condition that includes four entities: catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis and lung nodules. We describe the case of a 23-year-old woman with complaints of hemoptysis during menstrual period in the two years prior to the appointment. Initially, a treatment for tuberculosis was established with no success. Further investigation showed a 4 mm nodule in the right lung, and the transvaginal ultrasonography indicated the presence of deep endometriosis. Considering the occurrence of symptoms only during menses, an empirical therapy was instituted with remission of the complaints.

scholarly journals Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Dong ◽  
Chun-Li Wu ◽  
Yin-liang Sheng ◽  
Bin Wu ◽  
Guan-Chao Ye ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Lung Lesion ◽  
Parietal Pleura ◽  
Catamenial Pneumothorax ◽  
Endometrial Cells ◽  
Retrograde Menstruation ◽  
History Of ◽  
The Right ◽  
Thoracic Endometriosis

Abstract Background Catamenial pneumothorax is characterized by spontaneous recurring pneumothorax during menstruation, which is a common clinical manifestation of thoracic endometriosis syndrome. There are still controversies about its pathogenesis. Case presentation A 43-year-old woman with a history of endometriosis came to our hospital due to recurring pneumothorax during menstruation. Uniportal Video-assisted Thoracoscopic Surgery (VATS) exploration was performed on the eve of menstruating. We thoroughly explored the diaphragm, visceral and parietal pleura: The lung surface was scattered with yellowish-brown implants; no bullae were found; multiple diaphragmatic defects were found on the dome. And surprisingly, we caught a fascinating phenomenon: Bubbles were slipping into pleural cavity through diaphragmatic defects. We excised the diaphragmatic lesions and wedge resected the right upper lung lesion; cleared the deposits and flushed the thoracic cavity with pure iodophor. Diaphragmatic lesions confirmed the presence of endometriosis, and interestingly enough, microscopically, endometrial cells were shedding with impending menses. After a series of intraoperative operations and postoperative endocrine therapy, the disease did not recur after a period of follow-up. Conclusion We have witnessed the typical signs of catamenial pneumothorax at the accurate timing: Not only observed the process of gas migration macroscopically, but also obtained pathological evidence of diaphragmatic periodic perforation microscopically, which is especially precious and confirms the existing theory that retrograde menstruation leads to diaphragmatic endometriosis, and the diaphragmatic fenestration is obtained due to the periodic activities of ectopic endometrium.

scholarly journals A Case of Thoracic Endometriosis Syndrome Presenting with Recurrent Catamenial Pneumothorax

2018 ◽  
Vol 19 ◽  
pp. 573-576
Author(s):  
Shoaib Z. Junejo ◽  
Sandeep Singh Lubana ◽  
Sukhdip Singh Shina ◽  
Sandeep Singh Tuli
Keyword(s):  
Catamenial Pneumothorax ◽  
Thoracic Endometriosis
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