Clinical features of thoracic endometriosis: A single center analysis.
10.5468/ogs.2015.58.3.223
- Author:
Sun Mi HWANG
1
;
Chung Won LEE
;
Byung Seok LEE
;
Joo Hyun PARK
Author Information
1. Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. beanpearl@yuhs.ac
- Publication Type:Original Article
- Keywords:
Catamenial hemoptysis;
Catamenial pneumothorax;
Thoracic endometriosis
- MeSH:
Diagnosis;
Diagnosis, Differential;
Endometriosis*;
Female;
Follow-Up Studies;
Hemoptysis;
Humans;
Lung;
Medical Records;
Periodicity;
Pneumothorax;
Recurrence;
Retrospective Studies;
Thoracic Surgery, Video-Assisted;
Thoracotomy;
Thorax
- From:Obstetrics & Gynecology Science
2015;58(3):223-231
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To analyze the diagnostic profiles and treatment outcomes of patients with thoracic endometriosis at a university hospital. METHODS: A retrospective review of medical records was performed for patients diagnosed with thoracic endometriosis at Gangnam Severance Hospital, Yonsei University College of Medicine, between January 2007 and January 2014. RESULTS: Fifteen patients (median age, 35 years; range, 23-48 years) were evaluated. Patients presented with catamenial hemoptysis (n=8), or catamenial pneumothorax (n=7). Patients with catamenial pneumothorax were significantly older than those presenting with hemoptysis (P=0.0002). Only 3 patients (20%) had coexisting pelvic endometriosis. All patients underwent chest computed tomography; lesions were shown to predominantly affect the right lung (right lung, n=13, 86.7%; left lung, n=2, 13.3%), and were mainly distributed on the right upper lobe (n=9, 60%). Ten patients underwent video-assisted thoracoscopic surgery, and 1 patient underwent a thoracotomy. Intraoperatively, endometriosis-specific findings were observed in 8/11 patients (72.7%); a further 5/11 patients (45.4%) had histologically detectable endometriosis. Over the follow-up period (mean, 18.4 months; range, 2-65 months) 5/15 patients (33%) had clinical signs of recurrence. Recurrence was not detected in any of the 5 catamenial pneumothorax patients that received adjuvant hormonal therapy after surgery. CONCLUSION: The diagnosis and management of thoracic endometriosis requires a multidisciplinary approach, based upon skillful differential diagnosis, and involving careful gynecologic evaluation and assessment of the cyclicity of pulmonary symptoms. Imaging findings are non-specific, though there may be laterality towards the right lung. Since symptom recurrence is more common in those with presenting with pneumothorax, post-operative adjuvant medical therapy is recommended.
