Diaphragmatic endometriosis associated with pelvic endometriosis: a case report

Abstract Background Thoracic endometriosis is characterized by the presence of endometrial tissue in or around lungs and on the diaphragm and is frequently associated with pelvic endometriosis. Case presentation In this case report, a 22-year-old Caucasian patient reported right hypochondrium pain w...

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Main Authors: Rafael Tito Marques de Matos, Maria Célia Mendes, Maíra Cristina Ribeiro Andrade, Carolina Gennari Verruma, Rui Alberto Ferriani, Rosana Maria dos Reis
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Women's Health
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Online Access:https://doi.org/10.1186/s12905-025-03847-4
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author Rafael Tito Marques de Matos
Maria Célia Mendes
Maíra Cristina Ribeiro Andrade
Carolina Gennari Verruma
Rui Alberto Ferriani
Rosana Maria dos Reis
author_facet Rafael Tito Marques de Matos
Maria Célia Mendes
Maíra Cristina Ribeiro Andrade
Carolina Gennari Verruma
Rui Alberto Ferriani
Rosana Maria dos Reis
author_sort Rafael Tito Marques de Matos
collection DOAJ
description Abstract Background Thoracic endometriosis is characterized by the presence of endometrial tissue in or around lungs and on the diaphragm and is frequently associated with pelvic endometriosis. Case presentation In this case report, a 22-year-old Caucasian patient reported right hypochondrium pain without other associated symptoms and was diagnosed with cholelithiasis. She underwent laparoscopic cholecystectomy, and an abdominal cavity examination revealed a diaphragmatic endometriotic nodule and endometriosis foci in the right diaphragm, pelvic ligaments, and left adnexal area. During the procedure, excision of the diaphragmatic endometriotic nodule and cauterization of the larger endometriosis foci in the diaphragm were also performed. After surgery, hormone therapy was administered as complementary treatment, which included a depot gonadotrophin-releasing hormone (GnRH) agonist for 5 months, followed by drospirenone 4 mg/day for 3 months. At the follow-up visit, the patient reported an improvement in right hypochondrium pain after surgery and complete remission after clinical treatment. Magnetic resonance imaging (MRI) performed before and after 6 months following the initiation of hormone therapy revealed a regression of diaphragmatic and pelvic endometriosis foci. Conclusion In our case, the combination of surgical treatment and hormone therapy was effective for managing pelvic and diaphragmatic endometriosis.
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spelling doaj-art-7de4eb8189cd47b8b2dbfa85162aa4282025-08-20T03:45:32ZengBMCBMC Women's Health1472-68742025-07-012511710.1186/s12905-025-03847-4Diaphragmatic endometriosis associated with pelvic endometriosis: a case reportRafael Tito Marques de Matos0Maria Célia Mendes1Maíra Cristina Ribeiro Andrade2Carolina Gennari Verruma3Rui Alberto Ferriani4Rosana Maria dos Reis5Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São PauloDepartment of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São PauloDepartment of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São PauloDepartment of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São PauloDepartment of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São PauloDepartment of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São PauloAbstract Background Thoracic endometriosis is characterized by the presence of endometrial tissue in or around lungs and on the diaphragm and is frequently associated with pelvic endometriosis. Case presentation In this case report, a 22-year-old Caucasian patient reported right hypochondrium pain without other associated symptoms and was diagnosed with cholelithiasis. She underwent laparoscopic cholecystectomy, and an abdominal cavity examination revealed a diaphragmatic endometriotic nodule and endometriosis foci in the right diaphragm, pelvic ligaments, and left adnexal area. During the procedure, excision of the diaphragmatic endometriotic nodule and cauterization of the larger endometriosis foci in the diaphragm were also performed. After surgery, hormone therapy was administered as complementary treatment, which included a depot gonadotrophin-releasing hormone (GnRH) agonist for 5 months, followed by drospirenone 4 mg/day for 3 months. At the follow-up visit, the patient reported an improvement in right hypochondrium pain after surgery and complete remission after clinical treatment. Magnetic resonance imaging (MRI) performed before and after 6 months following the initiation of hormone therapy revealed a regression of diaphragmatic and pelvic endometriosis foci. Conclusion In our case, the combination of surgical treatment and hormone therapy was effective for managing pelvic and diaphragmatic endometriosis.https://doi.org/10.1186/s12905-025-03847-4Diaphragmatic endometriosisEndometrial tissueLaparoscopyExtrapelvic endometriosis
spellingShingle Rafael Tito Marques de Matos
Maria Célia Mendes
Maíra Cristina Ribeiro Andrade
Carolina Gennari Verruma
Rui Alberto Ferriani
Rosana Maria dos Reis
Diaphragmatic endometriosis associated with pelvic endometriosis: a case report
BMC Women's Health
Diaphragmatic endometriosis
Endometrial tissue
Laparoscopy
Extrapelvic endometriosis
title Diaphragmatic endometriosis associated with pelvic endometriosis: a case report
title_full Diaphragmatic endometriosis associated with pelvic endometriosis: a case report
title_fullStr Diaphragmatic endometriosis associated with pelvic endometriosis: a case report
title_full_unstemmed Diaphragmatic endometriosis associated with pelvic endometriosis: a case report
title_short Diaphragmatic endometriosis associated with pelvic endometriosis: a case report
title_sort diaphragmatic endometriosis associated with pelvic endometriosis a case report
topic Diaphragmatic endometriosis
Endometrial tissue
Laparoscopy
Extrapelvic endometriosis
url https://doi.org/10.1186/s12905-025-03847-4
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