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Endometriosis
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Ceana Nezhat, Pavan Ananth, Dahlia Admon
The most common site of endometriosis outside the abdominopelvic cavity is within the thoracic cavity. Implants may be found within the lung parenchyma, on pleural surfaces, or on the diaphragm. Thoracic endometriosis syndrome (TES) can produce a variety of clinical and radiologic manifestations, including catamenial: pneumothorax, hemothorax, hemoptysis, and pulmonary nodules. As a result, patients with TES often present to the emergency department with complaints of acute-onset chest pain, cough, or shortness of breath. Thoracic disease can occur in isolation, but in 50% to 84% of patients with this diagnosis, there is concomitant pelvic endometriosis, which is typically extensive [21–23].
Clinical features of endometriosis
Published in Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh, An Atlas of ENDOMETRIOSIS, 2020
Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh
Endometriosis of the lungs and thorax represents an uncommon site of extrapelvic endometriosis. Diagnosis is usually difficult because symptoms of thoracic endometriosis are similar to those of more common pulmonary pathologies, and presenting symptoms and signs usually include chest pain, pneumothorax, haemothorax or haemoptysis, usually concomitant with menstruation (Figures 3.27–3.29).
Diagnostic evaluation
Published in Seema Chopra, Endometriosis, 2020
Neha Agarwal, Seema Chopra, Arshi Syal
In the majority of the cases, the endometriosis remains confined to the pelvic cavity except the few exceptions of scar and thoracic endometriosis. In the order of decreasing frequency, the primary location of endometriosis are as follows: ovaries, uterine ligaments, pouch of Douglas, and peritoneal surfaces.
Mediastinal endometriosis with schwannoma: a case report
Published in Journal of Obstetrics and Gynaecology, 2022
Weihong Zhao, Yaqin Li, Honglei Zhang, Yatao Liu
Endometriosis predominantly affects women in the reproductive age group and is estimated to affect approximately 5−10% of the female population (Yang and Huang 2014). Pelvic pain is the most common symptom, occurring during or just before menstruation and ceasing after menstruation. Endometriosis lesions are primarily located on the pelvic peritoneum and ovaries. Thoracic endometriosis is a rare form of extrapelvic endometriosis, with two forms: pleural and pulmonary. The pleural form mainly presents with catamenial pneumothorax or hemothorax, while the pulmonary form presents with catamenial haemoptysis. All of these manifestations were unified as Thoracic Endometriosis Syndrome (TES) by Joseph and Sahn (Joseph and Sahn 1996). Endometriosis in the mediastinum is rarely reported. Shahar and Angelillo reported one case of mediastinal endometriosis with pneumomediastimum (Shahar and Angelillo 1986). To the best of our knowledge, mediastinal endometriosis is not yet reported.
Endometriosis: seeking optimal management in women approaching menopause
Published in Climacteric, 2019
L. Alio, S. Angioni, S. Arena, L. Bartiromo, V. Bergamini, N. Berlanda, V. Bonanni, C. Bonin, L. Buggio, M. Candiani, G. Centini, M. N. D'Alterio, F. De Stefano, A. Di Cello, C. Exacoustos, L. Fedele, M. P. Frattaruolo, E. Geraci, E. Lavarini, L. Lazzeri, S. Luisi, A. Maiorana, S. Makieva, F. Maneschi, F. Martire, C. Massarotti, A. Mattei, L. Muzii, J. Ottolina, L. Pagliardini, A. Perandini, F. Perelli, I. Pino, M. G. Porpora, V. Remorgida, G. Scagnelli, R. Seracchioli, E. Solima, E. Somigliana, G. Sorrenti, A. Ticino, R. Venturella, P. Viganò, M. Vignali, F. Zullo, E. Zupi
Consistent data on the management of thoracic endometriosis syndrome in the perimenopause period are lacking; five cases of thoracic endometriosis in women aged 40–50 years have been described51,56,57. Four cases reported a right-sided pneumothorax (80%) that seems to be the most frequent side for location of thoracic endometriosis, while in one case (20%) pneumothorax has not been reported but thoracic endometriosis syndrome was associated with the presence of right-sided pleural effusion and adhesions on the pleural surface with hemorrhagic spots57. The thoracic location of endometriosis was associated with an intestinal endometriosis in 20% of the cases56, while in another case the patient presented also adenomyosis, ovarian cyst, and ascites57. Clinically, chest pain during menstrual period was present in four cases (80%) and other respiratory symptoms, such as breathlessness, cough, and chest discomfort, have also been frequently reported in association (60%). The complete absence of thoracic clinical symptoms has been reported in two cases (40%). The management included medical treatment, mostly with GnRH-a and progestins (medroxyprogesterone acetate, cyproterone), and surgical treatment, represented by pleurodesis and/or hysterectomy and salpingo-oophorectomy. Thus, according to experience and data from observational studies, patients affected should be treated with hormonal therapy (COCs or progestins) if there are no serious side effects. However, if recurrence occurs during hormonal therapy or side effects are intolerable, bilateral salpingo-oophorectomy is indicated.
Thoracic endometriosis presented as catamental hemoptysis: a case series of a rare disease
Published in Current Medical Research and Opinion, 2021
Yi Dai, Meng-Hui Li, Yong-Jian Liu, Bing Liu, Yu-Shi Wu, Jing-He Lang, Zhen-Yu Zhang, Jin-Hua Leng
Thoracic endometriosis is characterized by the presence of functioning endometrial tissue in the pleura, lung parenchyma, airways, or diaphragm and was first described as early as 1912 by Hart9. Thoracic endometriosis is very rare and most of studies reporting it were either retrospective in design or case reports. To the best of our knowledge, we reported the largest case series of thoracic endometriosis presented as CH in China. In our cohort, the mean age of presentation was 30.21, which was similar with that reported in two large retrospective studies, that reported the peak incidence between 30 and 34 years22.