PMC10272489_01
Soft mobile non-tender umbilical mass proven by histopathology to be endometriosis related.
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Hormonal therapy was prescribed for three months, and an excisional biopsy was taken from an umbilical mass (Fig. 1) that occasionally bled during menses.
a. CXR at the time of initial presentation showing massive right sided pleural effusion in the upper and middle right lung zones. b. CXR done after thoracoscope. c. The last CXR before discharge. d. CXR done after one month of discharge by the time the patient had menstruation demonstrating re-accumulation of pleural effusion.
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A chest X-ray (Fig. 2a) revealed pleural effusion, and pleural tapping yielded bloody fluid that was sent for analysis and microscopy. During the patient's follow-up, re-accumulation of pleural fluid was discovered by an X-ray with her menstruation (Fig. 2d).
Thoracoscopic inspection of the parietal pleura revealing inflammation.
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Thoracoscopy showed extensively inflamed parietal pleura (Fig. 3), and a large bore chest tube was placed afterward.
Chest CT scan done after discharge, showing right sided pleural effusion with subtle pleural thickening and bilateral apical thickening.
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Chest computed tomography (CT) (Fig. 4) showed right pleural effusion with subtle pleural thickening and bilateral apical thickening, as well as mildly enlarged axillary lymph nodes mainly on the right.
Timeline of events since patient presentation until final treatment of the pleural effusion.
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Fig. 5 demonstrates the timeline order of events from the initial evaluation until the final treatment.