Bilateral Thoracic Endometriosis Affecting the Lung and Diaphragm
Open accessAbstract
INTRODUCTION: Endometriosis of the lung and the diaphragm is rare. Patients may present with symptoms such as shortness of breath, chest pain, and shoulder pain or they may be asymptomatic. Of note, there have been few reports of bilateral catamenial disease, and no reports, to our knowledge, of bilateral pathology proven pulmonary parenchymal endometriosis. CASE: A 43-year-old with stage IV endometriosis and large leiomyoma underwent a laparoscopic hysterectomy and treatment of endometrial lesions in 2005. In March and April of 2011, she presented with bilateral pneumothoraces. She subsequently underwent video-assisted thoracoscopy as well as resection and fulguration of bilateral lung and diaphragmatic endometriosis. Pathology confirmed endometrial implants in the lung parenchyma bilaterally. CONCLUSION: Catamenial pneumothorax is the most common presentation of thoracic endometriosis. However, bilateral catamenial pneumothoraces are rare. To the best of our knowledge, this case reflects the first report of pathology proven bilateral lung and diaphragm endometriosis.
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The most common site of endometriosis outside the abdominopelvic cavity is the thoracic cavity.
“The most common site of endometriosis outside of the abdominopelvic cavity is within the thoracic cavity8–10”
From Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management (2019) · cites this paper as [9]
The Discussion (page unavailable) identifies thoracic endometriosis as an extragenital manifestation and describes the most commonly reported sites within the thorax. It does not compare the thoracic cavity with other sites outside the abdominopelvic cavity, so it does not establish the claimed ranking. (LLM, conf=0.83)
Experimental — accuracy not yet measuredEndometriosis within the lung parenchyma or on the diaphragm and pleural surfaces produces catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis, and pulmonary nodules, collectively known as thoracic endometriosis syndrome (TES).
“Endometriosis within the lung parenchyma or on the diaphragm and pleural surfaces produces a range of clinical and radiological manifestations, including catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis, and pulmonary nodules. Collectively, this is known as thoracic endometriosis syndrome (TES).8–10”
From Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management (2019) · cites this paper as [9]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIsolated diaphragmatic endometriosis is typically asymptomatic but can result in irritation of the phrenic nerve, producing catamenial pain.
“Outside of the well-established clinical manifestations of TES, cases of isolated diaphragmatic endometriosis are typically asymptomatic but can result in irritation of the phrenic nerve. This can produce a syndrome of only catamenial pain, presenting as cyclic neck, shoulder, right upper quadrant, or epigastric pain.2,9,10,31,35–37”
From Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management (2019) · cites this paper as [9]
The Discussion reports that diaphragmatic lesions are common in thoracic endometriosis, and the Case Report describes a patient with diaphragmatic lesions and pneumothoraces; neither addresses isolated diaphragmatic endometriosis. Searches for asymptomatic disease, phrenic-nerve irritation, and cyclic neck, shoulder, upper-quadrant, or epigastric pain found no supporting passage in our copy. Page numbers were not provided. (LLM, conf=0.75)
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References 15 · Cited by 42
Research works printed but not linked: 14
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- [2]Maurer ER Schaal JA Mendez FL Jr Chronic recurring spontaneous pneumothorax due to endometriosis of the diaphragm. J Am Med Assoc. 12 13 1958; 168(15): 2013– 2014 13598643
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- [9]Rousset-Jablonski C Alifano M Plu-Bureau G Catamenial pneumothorax and endometriosis-related pneumothorax: clinical features and risk factors. Hum Reprod. 6 16 2011 21685141
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- Authors
- Nezhat, C., King, L. P., Paka, C., Odegaard, J., & Beygui, R.
- Affiliations
- University of California, San Francisco (US)
- Stanford Medicine (US)
- Corresponding author
- Nezhat, Camran
- Venue
- JSLS : Journal of the Society of Laparoendoscopic Surgeons
- Published
- 2012
- Volume
- 16
- Issue
- 1
- Pages
- 140-142
- ISSN
- 1086-8089 (ISSN-L)
- 1938-3797
- PMC
- PMC3407434
- OpenAlex
- W2089503094
- Cited by
- 42
- References
- 15
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 5 · 2016: 3 · 2015: 1 · 2014: 5
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- JSLS Journal of the Society of Laparoscopic & Robotic Surgeons (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Medical Imaging and Pathology Studies
- Keywords
- thoracic endometriosis, diaphragmatic endometriosis, catamenial pneumothorax, bilateral pneumothorax, video-assisted thoracoscopic surgery, fulguration, laparoscopic hysterectomy, leiomyoma
- MeSH terms
- Adult, Endometriosis, Female, Humans, Lung, Pneumothorax, Thoracic Surgery, Video-Assisted
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