ENDOMETRIOSE TORÁCICA COM MANIFESTAÇÕES PULMONARES: DESAFIOS DIAGNÓSTICOS E ESTRATÉGIAS DE MANEJO CLÍNICO E CIRÚRGICO – UMA REVISÃO SISTEMÁTICA

Amanda Lavínia Amarante Coutinho, Bárbara Junqueira Carvalho Coutinho, Beatriz Souza Esteves, Loreana Adrielle da Silva Pereira, Sirlene Célia Pereira Rosa
In: Revista DCS · 2026 · vol. 23(97) , pp. e7296 · doi:10.54899/dcs.v23i97.7296 · W7219907685
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This systematic review analyzes pulmonary endometriosis, identifying catamenial hemoptysis and recurrent pneumothorax as key diagnostic indicators while highlighting hormonal therapy and surgery as primary treatments amidst significant methodological limitations in current literature.

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This systematic review analyzes recent literature on pulmonary endometriosis, a rare extrapelvic manifestation characterized by ectopic endometrial tissue in the lungs. The authors identify catamenial hemoptysis, recurrent pneumothorax, and thoracic pain as key clinical indicators requiring high diagnostic suspicion in reproductive-age women. While hormonal therapy and surgical intervention remain primary management strategies, the paper notes that current evidence is limited by methodological flaws and a predominance of case reports. This paper is centrally about endometriosis — specifically thoracic and pulmonary manifestations involving catamenial symptoms and multidisciplinary management challenges.

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Abstract

A 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.
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ENDOMETRIOSE TORÁCICA COM MANIFESTAÇÕES PULMONARES: DESAFIOS DIAGNÓSTICOS E ESTRATÉGIAS DE MANEJO CLÍNICO E CIRÚRGICO – UMA REVISÃO SISTEMÁTICA DOI: https://doi.org/10.54899/dcs.v23i97.7296Palavras-chave: endometriose pulmonar, endometriose torácica, hemoptise catamenial, pneumotórax catamenial, diagnóstico, tratamentoResumo A 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. Downloads Referências ABOUJAOUDE, 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. AFZAL, 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. ANDRES, 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. BROWN, 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. 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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. SAKHARUK, 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. TONG, 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. VELAGAPUDI, 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. VERHULST, 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. VOLÁKOVÁ, 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. WANG, 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. ZANETTI, 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. Downloads Publicado Como Citar Edição Seção Licença Copyright (c) 2026 Revista DCS Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.

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