THORACIC ENDOMETRIOSIS - RECURRENCE FOLLOWING HYSTERECTOMY WITH BILATERAL SALPINGO-OOPHORECTOMY AND SUCCESSFUL TREATMENT WITH TALC PLEURODESIS

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.