{"paper_id":"46c1824a-88ab-4667-86eb-c38c39872a1d","body_text":"ENDOMETRIOSE TORÁCICA COM MANIFESTAÇÕES PULMONARES: DESAFIOS DIAGNÓSTICOS E ESTRATÉGIAS DE MANEJO CLÍNICO E CIRÚRGICO – UMA REVISÃO SISTEMÁTICA\nDOI:\nhttps://doi.org/10.54899/dcs.v23i97.7296Palavras-chave:\nendometriose pulmonar, endometriose torácica, hemoptise catamenial, pneumotórax catamenial, diagnóstico, tratamentoResumo\nA endometriose pulmonar é uma manifestação rara da endometriose torácica, caracterizada pela presença de tecido endometrial ectópico no pulmão, geralmente associada a sintomas respiratórios cíclicos em mulheres em idade reprodutiva. Esta revisão sistemática teve como objetivo analisar a literatura recente sobre endometriose pulmonar, com foco na fisiopatologia, apresentação clínica, métodos diagnósticos e abordagens terapêuticas. A busca foi realizada em bases científicas selecionadas, considerando estudos publicados entre 2015 e 2025, com triagem sistematizada e seleção conforme critérios de elegibilidade previamente definidos. Os achados evidenciaram predomínio de relatos de caso, séries clínicas e revisões, demonstrando que a hemoptise catamenial, a dor torácica, a dispneia e o pneumotórax recorrente constituem manifestações relevantes para suspeição diagnóstica. O diagnóstico mostrou-se dependente da integração entre história clínica, correlação com o ciclo menstrual, exames de imagem e, quando possível, confirmação histopatológica. Em relação ao tratamento, verificou-se que a terapia hormonal e a abordagem cirúrgica representam as principais estratégias terapêuticas, sendo a escolha definida conforme gravidade clínica, recorrência, extensão anatômica e necessidade de confirmação diagnóstica. Conclui-se que a endometriose pulmonar permanece subdiagnosticada, exige elevada suspeição clínica e demanda manejo multidisciplinar. Apesar do avanço das publicações recentes, a literatura ainda apresenta limitações metodológicas importantes, reforçando a necessidade de estudos mais robustos para padronização diagnóstica e terapêutica.\nDownloads\nReferências\nABOUJAOUDE, N.; ISKANDAR, M.; TANNOURI, F. Catamenial hemoptysis: a case report of pulmonary endometriosis. European Journal of Radiology Open, v. 8, 100302, 2021. DOI: https://doi.org/10.1016/j.ejro.2020.100302.\nAFZAL, A. et al. Catamenial pneumothorax with hepatic herniation. The Annals of Thoracic Surgery, v. 102, n. 5, p. e455, 2016. DOI: https://doi.org/10.1016/j.athoracsur.2016.02.112.\nANDRES, M. P. et al. Extrapelvic endometriosis: a systematic review. Journal of Minimally Invasive Gynecology, v. 27, n. 2, p. 373–389, 2020. DOI: https://doi.org/10.1016/j.jmig.2019.10.004.\nBROWN, A. et al. Endometriosis: a rare cause of multiple lung nodules on imaging. British Journal of Hospital Medicine, v. 79, n. 2, p. 110–111, 2018. DOI: https://doi.org/10.12968/hmed.2018.79.2.110.\nCHEN, C. et al. Thoracic endometriosis: a case report and review of the literature. Annals of Palliative Medicine, v. 10, n. 3, p. 3500–3503, 2021. DOI: https://doi.org/10.21037/apm-21-280.\nCIRIACO, P. et al. Treatment of thoracic endometriosis syndrome: a meta-analysis and review. The Annals of Thoracic Surgery, v. 113, n. 1, p. 324–336, 2022. DOI: https://doi.org/10.1016/j.athoracsur.2020.09.064.\nDAI, Y. et al. Thoracic endometriosis presented as catamental hemoptysis: a case series of a rare disease. Current Medical Research and Opinion, v. 37, n. 4, p. 685–691, 2021. DOI: https://doi.org/10.1080/03007995.2021.1885363.\nDAMPS-KONSTAŃSKA, I. et al. Catamenial pneumothorax—still an unveiled disease. Medicina, v. 60, n. 12, 2029, 2024. DOI: https://doi.org/10.3390/medicina60122029.\nDRIDI, D. et al. Clinical features and management of thoracic endometriosis: a 20-year monocentric retrospective study. Archives of Gynecology and Obstetrics, v. 311, n. 6, p. 1733–1742, 2025. DOI: https://doi.org/10.1007/s00404-025-08006-6.\nFUJIMOTO, K. et al. Pulmonary endometriosis which probably occurred through hematogenous metastasis after artificial abortion. Internal Medicine, v. 56, n. 11, p. 1405–1408, 2017. DOI: https://doi.org/10.2169/internalmedicine.56.8265.\nGIL, Y.; TULANDI, T. Diagnosis and treatment of catamenial pneumothorax: a systematic review. Journal of Minimally Invasive Gynecology, v. 27, n. 1, p. 48–53, 2020. DOI: https://doi.org/10.1016/j.jmig.2019.08.005.\nGUPTA, V. et al. A unique case of thoracic endometriosis syndrome and pulmonary Langerhans’ cell histiocytosis: six recurrent pneumothoraces. Respiratory Medicine Case Reports, v. 36, 101603, 2022. DOI: https://doi.org/10.1016/j.rmcr.2022.101603.\nICHIKI, Y. et al. Surgical treatment of catamenial pneumothorax: report of three cases. Asian Journal of Surgery, v. 38, n. 3, p. 180–185, 2015. DOI: https://doi.org/10.1016/j.asjsur.2013.09.014.\nJANG, H. I. et al. Catamenial hemoptysis accompanied by subcutaneous endometriosis treated with combination therapy. Obstetrics & Gynecology Science, v. 60, n. 2, p. 236–239, 2017. DOI: https://doi.org/10.5468/ogs.2017.60.2.236.\nJBI. Critical Appraisal Tools. Adelaide: JBI, 2026. Disponível em: https://jbi.global/critical-appraisal-tools. Acesso em: 10 ago. 2026.\nKALBI, D. P. et al. A thoracic endometriosis-related catamenial hemopneumothorax in a woman with premature ovarian failure. Cureus, v. 13, n. 8, e17110, 2021. DOI: https://doi.org/10.7759/cureus.17110.\nKAYA, C. et al. Catamenial pneumothorax: multidisciplinary minimally invasive management of a recurrent case. Kardiochirurgia i Torakochirurgia Polska, v. 17, n. 2, p. 107–109, 2020. DOI: https://doi.org/10.5114/kitp.2020.97274.\nKEIJZER, S. et al. Pathological diagnosis of thoracic endometriosis. BMJ Case Reports, v. 14, n. 8, e243258, 2021. DOI: https://doi.org/10.1136/bcr-2021-243258.\nKRISTJANSDOTTIR, A. et al. Catamenial pneumothorax due to pulmonary endometriosis. Laeknabladid, v. 107, n. 1, p. 24–27, 2021. DOI: https://doi.org/10.17992/lbl.2021.01.617.\nKYEJO, W. et al. Shortness of breath in a young lady, rare case report of thoracic endometriosis. International Journal of Surgery Case Reports, v. 95, 107226, 2022. DOI: https://doi.org/10.1016/j.ijscr.2022.107226.\nLAMEIRA, P. et al. Catamenial pneumothorax: a rare manifestation of endometriosis. Radiology Case Reports, v. 17, n. 9, p. 3119–3125, 2022. DOI: https://doi.org/10.1016/j.radcr.2022.06.012.\nLEONARDO-PINTO, J. P. et al. Hemoptysis and endometriosis: an unusual association—case report and review of the literature. Revista Brasileira de Ginecologia e Obstetrícia, v. 40, n. 5, p. 300–303, 2018. DOI: https://doi.org/10.1055/s-0038-1646780.\nLOW, Q. J. et al. Endometriosis: a rare cause of primary spontaneous pneumothorax. Medical Journal of Malaysia, v. 74, n. 5, p. 445–446, 2019. Disponível em: https://pubmed.ncbi.nlm.nih.gov/31649227/. Acesso em: 20 set. 2026.\nMUKKU, V. K. et al. Large spontaneous right catamenial pneumothorax with diaphragmatic defect and liver herniation. Case Reports in Pulmonology, v. 2019, 8436450, 2019. DOI: https://doi.org/10.1155/2019/8436450.\nMULETTE, P. et al. Pulmonary cavitations with increased 18F-FDG uptake revealing a thoracic endometriosis: a case report. Medicine, v. 100, n. 42, e27550, 2021. DOI: https://doi.org/10.1097/MD.0000000000027550.\nNAEM, A. et al. Diaphragmatic endometriosis—a single-center retrospective analysis of the patients’ demographics, symptomatology, and long-term treatment outcomes. Journal of Clinical Medicine, v. 12, n. 20, 6455, 2023. DOI: https://doi.org/10.3390/jcm12206455.\nNEZHAT, C. et al. Thoracic endometriosis syndrome: a review of diagnosis and management. JSLS, v. 23, n. 3, e2019.00029, 2019. DOI: https://doi.org/10.4293/JSLS.2019.00029.\nNEZHAT, C. et al. Thoracic endometriosis syndrome: a comprehensive review and multidisciplinary approach to management. Journal of Clinical Medicine, v. 13, n. 24, 7602, 2024. DOI: https://doi.org/10.3390/jcm13247602.\nNIKOLETTOS, K. et al. Pulmonary endometriosis: a systematic review. Journal of Personalized Medicine, v. 14, n. 11, 1085, 2024. DOI: https://doi.org/10.3390/jpm14111085.\nOUZZANI, M. et al. Rayyan—a web and mobile app for systematic reviews. Systematic Reviews, v. 5, 210, 2016. DOI: https://doi.org/10.1186/s13643-016-0384-4.\nPAGE, M. J. et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, v. 372, n160, 2021. DOI: https://doi.org/10.1136/bmj.n160.\nPAGE, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, v. 372, n71, 2021. DOI: https://doi.org/10.1136/bmj.n71.\nSAKAI, T. et al. Catamenial pneumothorax with pulmonary fistula identified during surgery. The Annals of Thoracic Surgery, v. 110, n. 3, p. e209–e211, 2020. DOI: https://doi.org/10.1016/j.athoracsur.2019.12.085.\nSAKHARUK, I. et al. Pleural endometriosis: an atypical cause of hemoptysis. The American Surgeon, v. 89, n. 7, p. 3292–3294, 2023. DOI: https://doi.org/10.1177/00031348231161715.\nTONG, S. S. et al. Case report of pulmonary endometriosis and review of the literature. Journal of International Medical Research, v. 47, n. 4, p. 1766–1770, 2019. DOI: https://doi.org/10.1177/0300060518800868.\nVELAGAPUDI, R. K.; EGAN, J. P. Thoracic endometriosis: a clinical review and update of current and evolving diagnostic and therapeutic techniques. Current Pulmonology Reports, v. 10, p. 22–29, 2021. DOI: https://doi.org/10.1007/s13665-021-00269-z.\nVERHULST, E. et al. Endometriotic lung cyst causing catamenial hemoptysis: a case report and review of literature. Acta Chirurgica Belgica, v. 122, n. 6, p. 432–437, 2022. DOI: https://doi.org/10.1080/00015458.2021.1887556.\nVOLÁKOVÁ, E. et al. Catamenial pneumothorax: case reports and literature review. Ceska Gynekologie, v. 82, n. 4, p. 308–312, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28925275/. Acesso em: 20 set. 2026.\nWANG, P. et al. Endometriosis-related pleural effusion: a case report and PRISMA-compliant systematic review. Frontiers in Medicine, v. 8, 631048, 2021. DOI: https://doi.org/10.3389/fmed.2021.631048.\nZANETTI, G.; HOCHHEGGER, B.; MARCHIORI, E. Pulmonary endometriosis: an unusual cause of hemoptysis. Jornal Brasileiro de Pneumologia, v. 46, n. 4, e20190335, 2020. DOI: https://doi.org/10.36416/1806-3756/e20190335.\nDownloads\nPublicado\nComo Citar\nEdição\nSeção\nLicença\nCopyright (c) 2026 Revista DCS\nEste trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.","source_license":"CC0","license_restricted":false}