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Case Reports
. 2012 May;27(5):603-7.
doi: 10.1007/s11606-011-1959-3. Epub 2012 Jan 11.

Thoracic endometriosis unmasked by ovarian hyperstimulation for in vitro fertilization

Stephanie A C Halvorson  1 , Mari A Ricker, Alan F Barker, Phillip E Patton, Rebecca A Harrison, Alan J Hunter
Affiliations
Case Reports

Thoracic endometriosis unmasked by ovarian hyperstimulation for in vitro fertilization

Stephanie A C Halvorson et al. J Gen Intern Med. 2012 May.

Abstract

Thoracic endometriosis syndrome is a well-described, rare manifestation of endometriosis. We present a case of a 35-year old woman undergoing controlled ovarian stimulation prior to in vitro fertilization (IVF) who developed bilateral hemorrhagic pleural effusions. She was initially diagnosed with ovarian hyperstimulation syndrome, a complication of infertility therapy; however, she was later found to have occult thoracic endometriosis. We describe ovarian hyperstimulation syndrome and review the manifestations of thoracic endometriosis syndrome. Although endometriosis is a hormone-dependent disease, the rate of IVF complications related to endometriosis is low.

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Figures

Figure 1.
Figure 1.
Chest CT performed 3 days after oocyte retrieval showing a large complicated right hydropneumothorax with pleural thickening and large left pleural effusion.
Figure 2.
Figure 2.
MRI showing herniation of much of the right lobe of the liver into the thoracic cavity.
Figure 3.
Figure 3.
Pleural pathology specimen demonstrating hemorrhage, pleural tissue and a tubular endometrial gland (arrow).
See this image and copyright information in PMC

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