Pulmonary endometriosis in a patient with unicornuate uterus and noncommunicating rudimentary horn

Objective: To report a rare case of a patient with catamenial hemoptysis, secondary infertility, and endometriosis associated with a unicornuate uterus and noncommunicating rudimentary horn. Design: Case report. Setting: University hospital. Patient(s): A 29-year-old woman who developed progressive catamenial hemoptysis and secondary infertility was evaluated at the University Hospital of Crete. Intervention (s): The complete history, laboratory data, laparoscopic findings, and chest magnetic resonance image of this patient were analyzed. A GnRH agonist, leuprolide acetate, was successfully administered. Main Outcome Measure(s): Diagnosis and appropriate treatment of pulmonary endometriosis in a patient with rudimentary uterine horn. Result(s): Treatment with a GnRH agonist achieved suppression of both menstruation and hemoptysis. After 6 months of normal menstrual activity, the symptoms reappeared. The patient was again treated with leuprolide acetate (3.75 mg/mo IM) for 6 months and remained asymptomatic. In fact, the patient became pregnant after cessation of therapy. Finally, the patient was treated successfully with removal of the rudimentary uterine horn during cesarean section. Three-year follow-up showed disappearance of the chest symptoms, Conclusion(s): Pulmonary endometriosis and unicornuate uteri are rare. To our knowledge. this is the first case of catamenial hemoptysis with a congenital mullerian anomaly. We describe successful management using a combination of GnRH agonist and surgical resection of the rudimentary uterine horn. (C) 2002 by American Society for Reproductive Medicine.