Endometriosis-associated pneumothoraxes

Ermakova E.I., Miroshina E.D., Ivanov I.A., Smetnik A.A.

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia
Background: Endometriosis involves the pelvic organs in the vast majority of cases; the extragenital location of endometrioid tissue is found more rarely, in nearly 12.9% of cases. One of the most common and simultaneously life-threatening forms of extragenital endometriosis is thoracic endometriosis (TE) that includes the foci localized on the pleura, diaphragm and in lung tissue.
Case report: A 48-year-old female patient P. complained of recurrent catamenial pneumothorax. She underwent pleural drainage, video-assisted thoracoscopy, resection of the tendon center of the diaphragm, and costal pleurectomy. Endometriosis of the diaphragm dome was diagnosed on the basis of the histological findings; gonadotropin-releasing hormone agonists were used for 6 months, followed by a switch to dienogest until menopause.
A 37-year-old female patient D. underwent chest and abdominal MRI for recurrent chest pain and dyspnea on the days of menstruation; however, no signs of endometriosis were found. Subsequent thoracoscopy revealed pleural endometriosis. When she joined the ART program, the patient was decided not to receive hormonal therapy because recurrent pneumothorax occurred after 3 months.
Conclusion: TE is a rare disease, the prevalence and pathogenesis of which are not fully understood. Since the diagnosis of the disease is often difficult; its treatment may be delayed; in view of that life-threatening pneumothorax may recur. A high clinical suspicion by therapists, pulmonologists, surgeons, and gynaecologists/endocrinologists is needed for timely diagnosis and better quality of life in patients with TE.


and catamenial endometriosis
hormonal therapy


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Received 11.11.2021

Accepted 17.11.2021

About the Authors

Elena I. Ermakova, PhD, Senior Researcher, Department of Endocrinological Gynecology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Ministry of Healthcare of Russian Federation, +7(916)848-37-46, e_ermakova@oparina4.ru, https://orcid.org/0000-0002-6629-051X,
117997, Russia, Moscow, Ac. Oparina str., 4.
Ekaterina D. Miroshina, postgraduate student, Junior Researcher, Department of Endocrinological Gynecology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Ministry of Healthcare of Russian Federation, +7(917)533-48-00, emiroshina.md@gmail.com, 117997, Russia, Moscow, Ac. Oparina str., 4.
Ilya A. Ivanov, PhD, Researcher, Department of Endocrinological Gynecology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Ministry of Healthcare of Russian Federation, +7(962)980-00-18, doctor.i.ivanov@yandex.ru, https://orcid.org/0000-0003-0751-7566, 117997, Russia, Moscow, Ac. Oparina str., 4.
Antonina A. Smetnik, Ph.D., Head of the Department of Endocrinological Gynecology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Ministry of Healthcare of Russian Federation, +7(495)531-44-44 ex. 1543, a_smetnik@oparina4.ru, 117997, Russia, Moscow, Ac. Oparina str., 4.

Authors' contributions: Smetnik A.A., Ermakova E.I. – concept and design of the investigation; editing; Miroshina E.D.,
Ivanov I.A. – data collection and processing; Miroshina E.D., Ivanov I.A., Ermakova E.I.: writing the text.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.

For citation: Ermakova E.I., Miroshina E.D., Ivanov I.A., Smetnik A.A.
Endometriosis-associated pneumothoraxes.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 12: 187-193 (in Russian)

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