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Nikolettos K, Patsouras A, Kotanidou S, Garmpis N, Psilopatis I, Garmpi A, Effraimidou EI, Daniilidis A, Dimitroulis D, Nikolettos N, Tsikouras P, Gerede A, Papoutsas D, Kontomanolis E, Damaskos C. Pulmonary Endometriosis: A Systematic Review. J Pers Med 2024; 14:1085. [PMID: 39590577 PMCID: PMC11595740 DOI: 10.3390/jpm14111085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Revised: 09/30/2024] [Accepted: 10/16/2024] [Indexed: 11/28/2024] Open
Abstract
Background/Objectives: Endometriosis is characterized by the presence of ectopic endometrial-like glands and stroma outside the endometrial cavity, which mainly occurs in the pelvic cavity. Pulmonary endometriosis, or thoracic endometriosis syndrome (TES), describes the rare presence of endometrial-like cells in the thoracic cavity and includes catamenial pneumothorax, catamenial hemothorax, hemoptysis, and lung nodules. Our aim is to summarize the results of all reported cases of TES. Methods: Extensive research was conducted through MEDLINE/PUBMED using the keywords "thoracic endometriosis", "thoracic endometriosis syndrome", "catamenial pneumothorax", "catamenial hemoptysis", and "TES". Following PRISMA guidelines, all published cases of TES between January 1950 and March 2024 were included. A systematic review of 202 studies in English, including 592 patients, was performed. Results: The median age of women with TES is 33.8 years old. The most common clinical presentation is catamenial pneumothorax (68.4%), while lesions are mainly found in the right lung unilaterally (79.9%). Chest computed tomography (CT) was used alone or after an X-ray to determine the pathological findings. Ground-glass opacity nodules and cystic lesions represent the most common finding in CT, while pneumothorax is the most common finding in X-rays. Video-assisted thoracoscopic surgery (VATS) is the main therapeutic approach, usually in combination with hormonal therapy, including GnRH analogues, progestins, androgens, or combined oral contraceptives. Hormonal therapy was also administered as monotherapy. Symptom recurrence was reported in 10.1% of all cases after the treatment. Conclusions: High clinical awareness and a multidisciplinary approach are necessary for the best clinical outcome for TES patients. More studies are required to extract safer conclusions.
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Affiliation(s)
- Konstantinos Nikolettos
- Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece; (K.N.); (S.K.); (N.N.); (P.T.); (A.G.); (E.K.)
| | - Alexandros Patsouras
- Second Department of Pulmonology, Sotiria General Hospital, 11527 Athens, Greece;
| | - Sonia Kotanidou
- Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece; (K.N.); (S.K.); (N.N.); (P.T.); (A.G.); (E.K.)
| | - Nikolaos Garmpis
- Department of Surgery, Sotiria General Hospital, 11527 Athens, Greece; (N.G.); (D.P.)
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Iason Psilopatis
- Department of Obstetrics and Gynecology, University Erlangen Hospital, 91054 Erlangen, Germany
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Eleni I. Effraimidou
- First Surgical Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece;
| | - Angelos Daniilidis
- First University Department in Obstetrics and Gynecology, Papageorgiou General Hospital, School of Medicine, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece;
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Nikos Nikolettos
- Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece; (K.N.); (S.K.); (N.N.); (P.T.); (A.G.); (E.K.)
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece; (K.N.); (S.K.); (N.N.); (P.T.); (A.G.); (E.K.)
| | - Angeliki Gerede
- Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece; (K.N.); (S.K.); (N.N.); (P.T.); (A.G.); (E.K.)
| | - Dimitrios Papoutsas
- Department of Surgery, Sotiria General Hospital, 11527 Athens, Greece; (N.G.); (D.P.)
| | - Emmanuel Kontomanolis
- Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece; (K.N.); (S.K.); (N.N.); (P.T.); (A.G.); (E.K.)
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Emergency Surgery, Laiko General Hospital, 11527 Athens, Greece
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Ouede R, Kone Z, Kohou-Kone L, Kouacou M, Okon G, Demine B, N’guessan E, Kendja K, Tanauh Y. Hémothorax cataménial : résultats de 11 cas opérés. Rev Mal Respir 2022; 39:221-227. [DOI: 10.1016/j.rmr.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 12/30/2021] [Indexed: 11/24/2022]
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Topbas Selcuki NF, Yilmaz S, Kaya C, Usta T, Kale A, Oral E. Thoracic Endometriosis: A Review Comparing 480 Patients Based on Catamenial and Noncatamenial Symptoms. J Minim Invasive Gynecol 2021; 29:41-55. [PMID: 34375738 DOI: 10.1016/j.jmig.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/15/2021] [Accepted: 08/01/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This review aimed to categorize thoracic endometriosis syndrome (TES) according to whether the presenting symptoms were catamenial and to evaluate whether such a categorization enables a better management strategy. DATA SOURCES An electronic search was conducted using the PubMed/Medline database. METHODS OF STUDY SELECTION The following keywords were used in combination with the Boolean operators AND OR: "thoracic endometriosis syndrome," "thoracic endometriosis," "diaphragm endometriosis," and "catamenial pneumothorax." TABULATION, INTEGRATION, AND RESULTS The initial search yielded 445 articles. Articles in non-English languages, those whose full texts were unavailable, and those that did not present the symptomatology clearly were further excluded. After these exclusions, the review included 240 articles and 480 patients: 61 patients in the noncatamenial group and 419 patients in the catamenial group. The groups differed significantly in presenting symptoms, surgical treatment techniques, and observed localization of endometriotic loci (p <.05). CONCLUSION This review points out the significant differences between patients with TES with catamenial and noncatamenial symptoms. Such categorization and awareness by clinicians of these differences among patients with TES can be helpful in designing a management strategy. When constructing management guidelines, these differences between patients with catamenial and noncatamenial symptoms should be taken into consideration.
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Affiliation(s)
- Nura Fitnat Topbas Selcuki
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Istanbul Sisli Hamidiye Etfal Training and Research Hospital (Dr. Topbas Selcuki)
| | - Salih Yilmaz
- Department of Obstetrics and Gynecology, Acibadem Altunizade Hospital (Dr. Yilmaz)
| | - Cihan Kaya
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, Acibadem Bakirkoy Hospital (Dr. Kaya)
| | - Taner Usta
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, Acibadem Altunizade Hospital (Dr. Usta).
| | - Ahmet Kale
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Istanbul Kartal Dr. Lutfi Kirdar City Hospital (Dr. Kale)
| | - Engin Oral
- Department of Obstetrics and Gynecology, Bezmialem Vakif University (Dr. Oral), Istanbul, Turkey
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Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator. PLoS One 2021; 16:e0251385. [PMID: 33984033 PMCID: PMC8118331 DOI: 10.1371/journal.pone.0251385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/24/2021] [Indexed: 11/19/2022] Open
Abstract
The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphological indicator(s) hitherto unrecognised as such, suggest diagnostic criteria; all with the aim of improving the diagnostic capacity and reducing observer error even where the clinical suspicion is low. A case-control study in which a search in the pathology archives of a referral hospital over a 10-year period was conducted. Twenty-six cases of TE were identified, reviewed, and compared with a control population of 48 cases taken from common benign thoracic diseases. Nine notable histological features were identified in varying permutations in the test group, namely: endometrioid glands, lymphoid clusters, ceroid macrophages, siderophages, cholesterol crystals, capillary congestion, multinucleated giant cells, smooth muscle bundles and fibrosis. The first 6 features were frequent; each being present in over 13 (13/26; 50%) test cases. The first 8 features showed significant association with TE by the Chi-squared test (P<0.05). In this group, the strength of association is high for the first 4 features (Cramér's V≥0.5). The presence of ceroid macrophages is shown to be a novel key feature, previously unrecognised as such, for the identification of TE. The presence of any three of four features including endometrioid glands, lymphoid clusters, ceroid macrophages and siderophages is a suggested criterion for the definitive diagnosis of TE.
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Wang P, Meng Z, Li Y, Xu Z. Endometriosis-Related Pleural Effusion: A Case Report and a PRISMA-Compliant Systematic Review. Front Med (Lausanne) 2021; 8:631048. [PMID: 33859990 PMCID: PMC8042286 DOI: 10.3389/fmed.2021.631048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Endometriosis-related pleural effusion (PE) is a relatively rare but treatable cause of bloody PE. The clinical characteristics and outcome of patients with endometriosis-related PE remain unknown. Objectives: We present a case of endometriosis-related PE diagnosed on pleural fluid cytology. A systematic review of all endometriosis-related PE cases in literature was conducted to elucidate the clinical characteristics, explore the diagnostic yield of pathological examinations, and to summarize the outcomes of therapeutic approaches in this disease. Methods: A case of endometriosis-related PE diagnosed in study hospital was reported. PubMed, Web of Science, and EMBASE were searched for publications pertaining to cases of endometriosis-related PE using predefined search terms. This case and those identified from PubMed, Web of Science, and EMBASE were analyzed. Results: A total of 67 patients were included. Catamential symptoms were presented in 30 (44.8%) patients. Dyspnea was presented in 50 patients (74.6%), followed by right chest/shoulder pain in 34 (50.7%) and cough in 18 (26.9%). 82.8% of the patients had concomitant pelvic endometriosis and 76.7% was infertile or nulliparous. The diagnostic yield of pleural fluid cytological examination, percutaneous pleural biopsy, and surgical biopsy was 9.0, 45.5, and 78.7%, respectively. The patients who received surgery-based therapy had a significantly longer time to relapse than those who received progestational agents or GnRH analogs alone (P = 0.025) or hysterectomy and bilateral salpingoophorectomy (HBSO) (P = 0.040). Conclusions: High clinical awareness of pleural endometriosis is essential in all female with hemorrhagic PE, especially in young females who have infertility and/or pelvic endometriosis. Plerual fluid cytology might be a simple minimally invasive and cost-effective modality in the diagnosis of endometriosis-related PE. Treatment is challenging due to high recurrence and the optimal management of endometriosis-related PE needs further evaluation. The combined approach by surgery and hormonal therapy may achieve the best relapse-free survival.
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Affiliation(s)
- Ping Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Zhilan Meng
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yakun Li
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.,Department of Pulmonary and Critical Care Medicine, Baoding No. 1 Hospital, Baoding, China
| | - Zuojun Xu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
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Hirata T, Koga K, Kai K, Katabuchi H, Kitade M, Kitawaki J, Kurihara M, Takazawa N, Tanaka T, Taniguchi F, Nakajima J, Narahara H, Harada T, Horie S, Honda R, Murono K, Yoshimura K, Osuga Y. Clinical practice guidelines for the treatment of extragenital endometriosis in Japan, 2018. J Obstet Gynaecol Res 2020; 46:2474-2487. [PMID: 33078482 PMCID: PMC7756675 DOI: 10.1111/jog.14522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/28/2020] [Indexed: 01/31/2023]
Abstract
The aim of this publication is to disseminate the clinical practice guidelines for the treatment of intestinal, bladder/ureteral, thoracic and umbilical endometriosis, already published in Japanese, to non-Japanese speakers. For developing the original Japanese guidelines, the clinical practice guideline committee was formed by the research team for extragenital endometriosis, which is part of the research program of intractable disease of the Japanese Ministry of Health, Labor and Welfare. The clinical practice guideline committee formulated eight clinical questions for the treatment of extragenital endometriosis, which were intestinal, bladder/ureteral, thoracic and umbilical endometriosis. The committee performed a systematic review of the literature to provide responses to clinical questions and developed clinical guidelines for extragenital endometriosis, according to the process proposed by the Medical Information Network Distribution Service. The recommendation level was determined using modified Delphi methods. The clinical practice guidelines were officially approved by the Japan Society of Obstetrics and Gynecology and the Japan Society of Endometriosis. This English version was translated from the Japanese version.
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Affiliation(s)
- Tetsuya Hirata
- Department of Obstetrics and GynecologyDoai Kinen HospitalTokyoJapan
- Department of Obstetrics and GynecologyUniversity of TokyoTokyoJapan
| | - Kaori Koga
- Department of Obstetrics and GynecologyUniversity of TokyoTokyoJapan
| | - Kentaro Kai
- Department of Obstetrics and GynecologyOita UniversityOitaJapan
| | | | - Mari Kitade
- Department of Obstetrics and GynecologyJuntendo UniversityTokyoJapan
| | - Jo Kitawaki
- Department of Obstetrics and GynecologyKyoto Prefectural UniversityKyotoJapan
| | - Masatoshi Kurihara
- Pneumothorax Research Center and Division of Thoracic SurgeryNissan Tamagawa HospitalTokyoJapan
| | | | - Toshiaki Tanaka
- Department of Surgical OncologyUniversity of TokyoTokyoJapan
- Department of SurgeryInternational Catholic HospitalTokyoJapan
| | | | - Jun Nakajima
- Department of Thoracic SurgeryUniversity of TokyoTokyoJapan
| | | | - Tasuku Harada
- Department of Obstetrics and GynecologyTottori UniversityTottoriJapan
| | - Shigeo Horie
- Department of UrologyJuntendo UniversityTokyoJapan
| | - Ritsuo Honda
- Department of Obstetrics and GynecologyKumamoto UniversityKumamotoJapan
| | - Koji Murono
- Department of Surgical OncologyUniversity of TokyoTokyoJapan
| | - Kotaro Yoshimura
- Department of Plastic SurgeryJichi Medical UniversityShimotsukeJapan
| | - Yutaka Osuga
- Department of Obstetrics and GynecologyUniversity of TokyoTokyoJapan
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Gil Y, Tulandi T. Diagnosis and Treatment of Catamenial Pneumothorax: A Systematic Review. J Minim Invasive Gynecol 2020; 27:48-53. [DOI: 10.1016/j.jmig.2019.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 07/30/2019] [Accepted: 08/04/2019] [Indexed: 01/07/2023]
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Pathak S, Caruana E, Chowdhry F. Should surgical treatment of catamenial pneumothorax include diaphragmatic repair? Interact Cardiovasc Thorac Surg 2019; 29:906-910. [PMID: 31504553 DOI: 10.1093/icvts/ivz205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 06/10/2019] [Accepted: 07/25/2019] [Indexed: 11/13/2022] Open
Abstract
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether treatment with hormones or pleural symphysis is better than operative procedures such as diaphragmatic repair with mesh to surgically manage recurrent pneumothoraces in patients with catamenial pneumothorax. Diaphragmatic repair with synthetic meshes, hormonal treatment and pleural symphysis are all accepted interventions for the treatment of recurrent catamenial pneumothoraces; however, there is uncertainty over the best combination of treatment. Altogether, 396 papers were found using the reported search, of which 13 represented the best evidence to answer the clinical question. However, it should be noted that the studies included were small in terms of sample size, and have demonstrated significant bias and surgical heterogeneity. Our literature review found that the recurrence rates of pneumothorax were greatly reduced in the treatment group where surgery and hormone therapy were combined (pooled average recurrence rate of 0%); however, the recurrence rates were significantly higher when these interventions were used alone: hormone therapy alone (58.5%), diaphragmatic repair alone (33.3%) and surgery alone (63.3%). Our results therefore demonstrate that a multimodality approach is required to reduce pneumothorax recurrence rates in patients with catamenial pneumothorax.
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Affiliation(s)
- Suraj Pathak
- Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK
| | - Edward Caruana
- Department of Thoracic surgery, Nottingham City Hospital, Nottingham, UK
| | - Fiyaz Chowdhry
- Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK
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AlAqeel S, AlJehani Y, AlMuhaish M. Bilateral catamenial hemopneumothorax: Diagnostic & management challenges. Int J Surg Case Rep 2019; 61:271-274. [PMID: 31398668 PMCID: PMC6699417 DOI: 10.1016/j.ijscr.2019.07.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Catamenial pneumothorax (CP) is a rare and usually miss diagnosed condition that is often characterized by non- specific respiratory or gynecological symptoms. A high index of suspicion is warranted for early diagnosis and management. PRESENTATION OF CASE We present a case of 34 year old female who presented with shortness of breath and dyspnea. DISCUSSION The radiological diagnosis was pneumothorax with further history, it was apparent that is was a case of primary infertility secondary to possible pelvic endometriosis. She was treated as a case of bilateral catamenial hemopneumothorax after confirming the diagnosis through surgical exploration & repair of right hemidiaphragm. CONCLUSIONS This case demonstrate the extensive bilateral catamenial hemopnemothorax which is limitedly described in the literature index of suspicion & early diagnosis and management would ensure multiple admission & recurrence.
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Affiliation(s)
- S AlAqeel
- National Guard Hospital, Al-Ahsa, P.O. BOX: 3165, Dammam, Saudi Arabia.
| | - Y AlJehani
- King Fahad University Hospital, P.O. BOX 31774, Khobar, 31952, Saudi Arabia.
| | - M AlMuhaish
- King Fahad University Hospital, P.O. BOX 31774, Khobar, 31952, Saudi Arabia.
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Larraín D, Suárez F, Braun H, Chapochnick J, Diaz L, Rojas I. Thoracic and diaphragmatic endometriosis: Single-institution experience using novel, broadened diagnostic criteria. J Turk Ger Gynecol Assoc 2018; 19:116-121. [PMID: 29865779 PMCID: PMC6085532 DOI: 10.4274/jtgga.2018.0035] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To describe our experience with the multidisciplinary management of both thoracic/diaphragmatic endometriosis (TED), applying a broadened definition of the “Thoracic endometriosis syndrome (TES)” to define cases. Material and Methods: We present a retrospective series of consecutive patients affected by pathology-proven TED, treated at our institution, during a period of 7 years. Results: Five women were included. Two patients were referred due to catamenial chest/shoulder pain, one due to recurrent catamenial pneumothorax, and one due to new-onset diaphragmatic hernia. One patient had no thoracic symptoms, but diaphragmatic endometriosis was found during gynecologic laparoscopy for pelvic endometriosis. Endometriosis was histologically confirmed in all cases. After follow-up, all patients remain asymptomatic. Conclusion: Broadened TES criteria could increase the incidence of TED and determine better knowledge of this condition. Multidisciplinary, minimally invasive surgery is effective and safe, but should be reserved for tertiary referral centers.
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Affiliation(s)
- Demetrio Larraín
- Department of Obstetrics and Gynecology, Endometriosis Unit, Clínica Santa María, Santiago, Chile,Department of Obstetrics and Gynecology, Clínica Santa María, Santiago, Chile
| | - Francisco Suárez
- Department of Thoracic Surgery, Clínica Santa María, Santiago, Chile
| | - Hernán Braun
- Department of Obstetrics and Gynecology, Clínica Santa María, Santiago, Chile
| | - Javier Chapochnick
- Department of Hepatobiliary Surgery, Clínica Santa María, Santiago, Chile
| | - Lidia Diaz
- Department of Pathology, Clínica Santa María, Santiago, Chile
| | - Iván Rojas
- Department of Obstetrics and Gynecology, Clínica Santa María, Santiago, Chile
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Fukuda S, Hirata T, Neriishi K, Nakazawa A, Takamura M, Izumi G, Harada M, Hirota Y, Koga K, Wada-Hiraike O, Fujii T, Osuga Y. Thoracic endometriosis syndrome: Comparison between catamenial pneumothorax or endometriosis-related pneumothorax and catamenial hemoptysis. Eur J Obstet Gynecol Reprod Biol 2018; 225:118-123. [DOI: 10.1016/j.ejogrb.2018.04.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/12/2018] [Accepted: 04/16/2018] [Indexed: 11/30/2022]
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12
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Merlot B, Ploteau S, Abergel A, Rubob C, Hocke C, Canis M, Fritel X, Roman H, Collinet P. [Extragenital endometriosis: Parietal, thoracic, diaphragmatic and nervous lesions. CNGOF-HAS Endometriosis Guidelines]. ACTA ACUST UNITED AC 2018. [PMID: 29530553 DOI: 10.1016/j.gofs.2018.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
According to some studies, extragenital endometriosis represents 5% of the localisations. Its prevalence seems to be underestimated. The extra pelvic localisation can make the diagnosis more difficult. Nevertheless, the recurrent and catamenial symptomatology can evoke this pathology. Surgery seems to be the unique efficient treatment for parietal lesions. Pain linked to nervous lesions (peripheric and sacral roots) seems to be underestimated and difficult to diagnose because of various localisations. Neurolysis seems to have encouraging results. Diaphragmatic lesions are often discovered either incidentally during laparoscopy, or by pulmonary symptomatology as recurrent catamenial pneumothorax or cyclic thoracic pain. Surgical treatment seems as well to be efficient.
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Affiliation(s)
- B Merlot
- Service de chirurgie gynécologique, clinique Tivoli, 220, rue Mandron, 33000 Bordeaux, France.
| | - S Ploteau
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital mère-enfant, CHU de Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France
| | - A Abergel
- Médecine de la reproduction, clinique Jean-Villar, avenue Maryse-Bastié, 33520 Bruges, France
| | - C Rubob
- Clinique de gynécologie, hôpital Jeanne-de-Flandre, université Lille-Nord-de-France, CHRU de Lille, 59000 Lille, France
| | - C Hocke
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor-d'Aquitaine, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France
| | - M Canis
- Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - X Fritel
- Service de gynécologie-obstétrique et médecine de la reproduction, Inserm CIC 1402, université de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - H Roman
- Centre expert de diagnostic et prise en charge multidisciplinaire de l'endométriose, clinique gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France
| | - P Collinet
- Clinique de gynécologie, hôpital Jeanne-de-Flandre, université Lille-Nord-de-France, CHRU de Lille, 59000 Lille, France
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Dienogest Therapy as a Treatment for Catamenial Pneumothorax: Case Report and Review of Hormonal Options. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017. [DOI: 10.1016/j.jogc.2017.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Catamenial pneumothorax since introduction of video-assisted thoracoscopic surgery. Wien Klin Wochenschr 2017; 129:717-726. [PMID: 28762057 DOI: 10.1007/s00508-017-1237-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 07/08/2017] [Indexed: 10/19/2022]
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Nair SS, Nayar J. Thoracic Endometriosis Syndrome: A Veritable Pandora's Box. J Clin Diagn Res 2016; 10:QR04-8. [PMID: 27190904 DOI: 10.7860/jcdr/2016/17668.7700] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/03/2016] [Indexed: 11/24/2022]
Abstract
Thoracic endometriosis syndrome is a rare disorder characterised by the presence of functioning endometrial tissue in pleura, lung parenchyma, airways, and/or encompasses mainly four clinical entities-catamenial pneumothorax, catamenial haemothorax, catamenial haemoptysis and lung nodules. The cases were studied retrospectively by reviewing the records at Amrita Institute of Medical Sciences, for duration of five years i.e., form March 2010-2014 and analysed for the clinical presentation and management of thoracic endometriosis syndrome. Catamenial breathlessness was the main symptom. Pneumothorax and pleural effusion were the findings on investigations. Histopathology report of endometriosis was present in three cases (50%). Conditions with excess oestrogen like endometriosis, fibroid, adenomyosis were diagnosed in these patients by pelvic scan. After the initial supportive treatment with hormones, pleurodesis, hysterectomy and lung decortication were the treatment modalities. Two cases that had multiple recurrences were diagnosed as disseminated TES. They underwent combined treatment of surgery and hormones.
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Affiliation(s)
- Sobha S Nair
- Assisstant Professor, Department of Obstetrics and Gynaecology, Amrita Institute of Medical Sciences , Kochi, Kerala, India
| | - Jayashree Nayar
- Professor, Department of Obstetrics and Gynaecology, Amrita Institute of Medical Sciences , Kochi, Kerala, India
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