J. Joseph et al., THORACIC ENDOMETRIOSIS - RECURRENCE FOLLOWING HYSTERECTOMY WITH BILATERAL SALPINGO-OOPHORECTOMY AND SUCCESSFUL TREATMENT WITH TALC PLEURODESIS, Chest, 106(6), 1994, pp. 1894-1896
This is a report of an unusual patient who had four of the five manife
stations of thoracic endometriosis, including right pneumothorax, left
hemothorax, chest pain, and hemoptysis. This patient shows that recur
rence of symptoms can occur while a patient is receiving hormonal repl
acement therapy even after hysterectomy and bilateral salpingo-oophore
ctomy; estrogen replacement should probably be delayed for several mon
ths to allow complete regression of the ectopic endometrial tissue. Al
ternatively, chemical pleurodesis can be effective in treating recurre
nt pneumothorax or hemothorax while the patient is receiving hormonal
replacement. Bilateral pleural involvement and hemoptysis suggest micr
oembolization of endometrial tissue as the pathogenic mechanism for th
oracic endometriosis.