Bilateral thoracic endometriosis affecting the lung and diaphragm.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
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.
Center for Minimally Invasive and Robotic Surgery, Stanford University Medical Center Departments of Obstetrics and Gynecology and Surgery, Palo Alto, CA, USA. cnezhat@stanford.edu
Camran
C
Nezhat
Louise P
LP
King
Chandhana
C
Paka
Justin
J
Odegaard
Ramin
R
Beygui
D000328:Adult; D004715:Endometriosis / Q000150:complications*; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology; D011030:Pneumothorax / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted