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Vol. 14. Issue 3.
Pages 427-435 (May - June 2008)
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Vol. 14. Issue 3.
Pages 427-435 (May - June 2008)
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Endometriose torácica
Thoracic endometriosis
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1847
Filipa Costa1, Fernando Matos2, Jorge Pires3,
1 Interna do Internato Complementar de Pneumologia
2 Assistente Hospitalar Graduado de Pneumologia
3 Serviço de Pneumologia Centro Hospitalar de Coimbra
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A endometriose torácica define-se pela presença de tecido endometrial no pulmão ou pleura e manifesta--se clinicamente por hemoptises cíclicas, pneumotórax ou hemotórax recorrente coincidentes com a menstruação. Tratando-se de uma patologia rara, nem sempre é considerada no diagnóstico diferencial quando se avaliam estas manifestações. Os exames complementares de diagnóstico geralmente não revelam alterações específicas, sendo o diagnóstico feito com base na história clínica. A chave do diagnóstico são os sintomas catameniais, sendo fundamental realizar uma história clínica minuciosa para chegar atempadamente ao diagnóstico correcto. O tratamento hormonal e a cirurgia são as duas alternativas terapêuticas para esta patologia.

Os autores descrevem o caso clínico de uma doente de 27 anos que surge com um quadro de hemoptises catameniais. Os exames complementares de diagnóstico realizados foram inconclusivos. Baseado na história clínica, assumiu-se o diagnóstico de endometriose pulmonar e iniciou-se tratamento com contraceptivos orais com resolução total dos sintomas.

A propósito do caso clínico, os autores fazem uma revisão das principais manifestações clínicas, da patogénese, do diagnóstico e do tratamento da endometriose torácica.

Palavras-chave:
Endometriose torácica
endometriose pulmonar
endometriose pleural
hemoptises
pneumotórax
hemotórax
catamenial
Abstract

Thoracic endometriosis is defined by the presence of endometrial tissue in the lungs or pleura, and is characterised by cyclic hemoptysis or recurrent hemothorax or pneumothorax occurring with the menstruation. Being a rare clinical entity, it is not always considered in the differential diagnosis when these symptoms are evaluated. The exams performed during the diagnostic work-up frequently show nonspecific alterations, however a presumptive diagnosis can be made based on the typical clinical history. The key to the diagnosis are the catamenial symptoms, so a thorough clinical history is essential to promptly reach the correct diagnosis. Hormonal treatment and surgery are the two mainstays of therapy for this pathology.

The authors present the case of a 27 year-old female patient presenting with cyclic hemoptysis during the menstruation. The diagnostic workup was inconclusive. Based on the clinical history, the diagnosis of pulmonary endometriosis was assumed and treatment was initiated with oral contraceptives with total resolution of symptoms.

The authors make a brief review of the main symptoms, pathogenesis, diagnosis and treatment of thoracic endometriosis.

Key-words:
Thoracic endometriosis
pulmonary endometriosis
pleural endometriosis
hemoptysis
pneumothorax
hemothorax
catamenial
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Bibliografia
[1.]
R.A. Grunewald, J. Wiggins.
Pulmonary endometriosis mimicking acute abdomen.
Postgrad Med J, 64 (1988), pp. 865-866
[2.]
Z. Yu, J.K. Fleischman, H.M. Rahman, A.F. Mesia, F. Rosner.
Catamenial hemoptysis and pulmonary endometriosis: a case report.
Mount Sinai J Med, 69 (2002), pp. 261-263
[3.]
O.H. Schwarz.
Endometriosis of the lung.
Am J Obstet Gynecol, 36 (1938), pp. 887-889
[4.]
D.L. Olive, L.B. Schwartz.
Endometriosis.
N Engl J Med, 328 (1993), pp. 1759-1769
[5.]
M.K. Shepard, G.D. Campbell, R. George.
Right-sided hemothorax and recurrent abdominal pain in a 34-year-old woman.
Chest, 103 (1993), pp. 1239-1240
[6.]
J.P. Karpel, D. Appel, A. Merav.
Pulmonary endometriosis.
Lung, 163 (1985), pp. 151-159
[7.]
J.A. Sampson.
Peritoneal endometriosis due to menstrual dissemination of endometrial tissue into the peritoneal cavity.
Am J Obstet Gynecol, 14 (1927), pp. 422-469
[8.]
P.C. Cassina, M. Hauser, G. Kacl, B. Imthurn, S. Schroder, W. Weder.
Catamenial hemoptysis Diagnosis with MRI.
Chest, 111 (1997), pp. 1447-1450
[9.]
D.C. Foster, J.L. Stern, J. Buscema, J.A. Rock, J.D. Woodruff.
Pleural and parenchymal pulmonary endometriosis.
Obstet Gynecol, 58 (1981), pp. 552-556
[10.]
S.M. Markham, S.E. Carpenter, J.A. Rock.
Extrapelvic endometriosis.
Obstet Gynecol Clin North Am, 16 (1989), pp. 193-207
[11.]
J. Joseph, S.A. Sahn.
Thoracic endometriosis syndrome: New observations from an analysis of 110 cases.
Am J Med, 100 (1996), pp. 164-170
[12.]
N.L. Muller, B. Nelems.
Postcoital catamenial pneumothorax.
Am Rev respir Dis, 134 (1986), pp. 803-804
[13.]
I. Grangberg, J.A. Willems.
Endometriosis of lung and pleura diagnosed by aspiration biopsy.
Acta Cytol, 21 (1997), pp. 295-297
[14.]
Y. Tsunezuka, H. Sato, T. Kodama, et al.
Expression of CA125 in thoracic endometriosis in a patient with catamenial pneumothorax.
Respiration, 66 (1999), pp. 470
[15.]
R. Orriols, X. Munoz, A. Alvarez, G. Sampol, C.T. Chest.
scanning: utility in lung endometriosis.
Respir Med, 92 (1998), pp. 876-877
[16.]
J.R. Volkart.
CT findings in pulmonary endometriosis.
J Comput Assist Tomogr, 19 (1995), pp. 156-157
[17.]
D.L. Elliot, A.F. Barker, L.M. Dixon.
Catamenial hemoptysis: new methods of diagnosis and therapy.
Chest, 87 (1985), pp. 687-688
[18.]
Y. Shek, J.D. Lia, R.A. Pattillo.
Endometriosis with a pleural effusion and ascities: report of a case treated with nafarelin acetate.
J Reprod Med, 40 (1995), pp. 540-542
[19.]
L.T. Hibbard, W.R. Schumann, G.E. Goldstein.
Thoracic endometriosis: a review and report of two cases.
Am J Obstet Gynecol, 140 (1981), pp. 227-232
[20.]
O. Katoh, H. Yamada, Y. Aoki, et al.
Utility of angiograms in patients with catamenial hemoptysis.
Chest, 98 (1990), pp. 1296-1297
[21.]
H. Slabbynck, N. Impens, W. Schandevyl.
Recurring catamenial pneumothorax treated with Gn-RH analogue.
Chest, 100 (1991), pp. 851
[22.]
T. Koizumi, H. Inagaki, Y. Takabayashi, K. Kubo.
Successful use of gonadotropin releasing hormone agonist in a patient with pulmonary endometriosis.
Respiration, 66 (1999), pp. 544-546
[23.]
H. Black, D. Sigal, D. Barnes, et al.
A 25-year-old patient with spontaneous hemothorax.
Chest, 128 (2005), pp. 3080-3083
[24.]
W.M. Johnson, C.M. Tyndal.
Pulmonary endometriosisTreatment with danazol.
Obstet Gynecol, 69 (1987), pp. 506-507
[25.]
K. Horsfield.
Catamenial pleural pain.
Eur Respir J, 2 (1989), pp. 1013-1014
[26.]
M.M. Johnson.
Catamenial pneumothorax and other thoracic manifestations of endometriosis.
Clin Chest Med, 25 (2004), pp. 311-319
[27.]
J. Joseph.
Thoracic endometriosis: recurrence following hysterectomy with bilateral salpingo-oophorectomy and successful treatment with talc pleurodesis.
Chest, 106 (1994), pp. 1894-1896
[28.]
D.S. Bhatia, P.M. McFadden, R.C. Kline.
Recurrent catamenial hemopneumothorax.
South Med J, 91 (1998), pp. 398-401
[29.]
L.D. Erickson, S.J. Ory.
GnRH analogues in the treatment of endometriosis.
Obstet Gynecol Clin North Am, 16 (1989), pp. 123-146
[30.]
P. Bagan, F. Le Pimpec Barthes, J. Assouad, et al.
Catamenial pneumothorax : retrospective study of surgical treatment.
Ann Thorac Surg, 75 (2003), pp. 378-381
[31.]
V.L. Seltzer, F. Benjamin.
Treatment of pulmonary endometriosis with a long acting GnRH agonist.
Obstet Gynecol, 76 (1990), pp. 929-931
Copyright © 2008. Sociedade Portuguesa de Pneumologia
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