Thoracic endometriosis is a rare condition where the endometrial tissue grows on the pleural surface or the lungs. TE affects women usually around the age of 30 to 35. Recent research has shown that 80% of the cases happen around the menstrual periods. Unfortunately, the diagnosis is often delayed, which results in other complications and recurrent hospitalizations.
What causes thoracic endometriosis?
The cause of TE is still unknown. However, medical experts believe that the menstrual blood flows backward through the fallopian tubes to the pelvic cavity. Endometrial fragments are then deposited into the pelvis and grow into lesions. This theory has many flaws. For instance, experts are yet to explain how endometriosis can exist outside the pelvis.
Signs and symptoms
The typical symptoms include breathlessness, chest pain and cough. They occur within 72 hours following the onset of menstruation. Other symptoms include painful menstrual cramps which get worse over time, heavy menstrual periods and painful urination during periods. Also, the patient may have a radiating neck pain as a result of diaphragmatic irritation. These symptoms can range from one patient to another.
New findings by the US National Library of Medicine show that the diagnosis is often delayed, sometimes up to 8 months. In fact, some patients have reported diagnostic delays by up to 4 years. When the signs are detected early, there are high chances of making the right diagnosis and prescribing the right treatment.
The patient can undergo hormonal therapy or have surgical intervention. Unfortunately, hormonal therapy alone is associated with recurrence after about six months. According to a recent study done by Dr. Nicholas Kongoasa from the Center for Endometriosis Care, 14% of the patients will have the condition on the right side of the chest. With this in mind, the diaphragm has to be examined thoroughly.
What's more, the thoracic surgeon may have to do some magnetic resonance imaging (MRI) before the surgery. Dr. Nicholas believes that if surgical treatment is done within 6 to 12 months after diagnosis, there are lower chances of recurrence. He recommends a combination of hormonal therapy and surgical procedure.
Any woman who reports cyclical chest pain during her reproductive years could be suffering from TE. While it remains unclear how the endometrial tissue can migrate to the thoracic area, a comprehensive radiological and physical examination should be done to such patients. Plus, of course, women of reproductive age should undergo regular screening to find out if there are any lesions on their pleural cavity.