Pulmonary Adenomyosis in a Post-Menopausal Woman: a Rare Variant of Pulmonary Endometriosis. Case Presentation
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Abstract
We present the case of a 48-year-old woman with the incidental finding of pulmonary nodules during preoperative evaluation. She reported a history of hysterectomy for uterine fibroids without oophorectomy at age 30 and resection of breast nodules for fibroadenomas. A chest computed tomography scan confirmed multiple nodules in both lungs. Lung biopsy revealed endometrial glands surrounded by stroma and smooth muscle without atypia, with immunohistochemistry positive for smooth muscle actin, calponin, CD10, estrogen receptors, and cytokeratins AE1/AE3. The histopathological diagnosis was consistent with pulmonary adenomyosis, an uncommon form of Thoracic Endometriosis Syndrome (TES).
Given the patient's asymptomatic nature and the nodular presentation of the lesions without evidence of adjacent complications, a conservative management approach was chosen, including periodic clinical and radiological follow-up, prioritizing close monitoring for any morphological or symptomatic changes that might warrant more active intervention. This case highlights the importance of considering benign entities such as pulmonary adenomyosis in the differential diagnosis of pulmonary nodules.
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