Clinical features of thoracic endometriosis: A single center analysis

Sun Mi Hwang, Chung Won Lee, Byung Seok Lee, Joo Hyun Park
Obstetrics & gynecology science · 2015 · vol. 58(3) , pp. 223 · doi:10.5468/ogs.2015.58.3.223 · PMID:26023672 · PMC4444519 · W1904650577
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study analyzed 15 thoracic endometriosis patients presenting with catamenial hemoptysis or pneumothorax, finding lesions predominantly in the right lung and a 33% recurrence rate, with hormonal therapy potentially reducing recurrence in pneumothorax cases.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This single-center retrospective study reviewed medical records (2007–2014) of 15 reproductive-age women diagnosed with thoracic endometriosis, examining demographics, catamenial symptom patterns, imaging and intraoperative findings, histopathology, treatment approaches, and recurrence during an average follow-up of 18.4 months. The main presentations were catamenial hemoptysis (n=8) and catamenial pneumothorax (n=7), with CT showing predominantly right-sided lung lesions (right lung 86.7%, mainly right upper lobe) and intraoperative endometriosis-specific findings in 72.7% of evaluable patients, while only 20% had coexisting pelvic endometriosis. Clinical recurrence occurred in 33% overall, and none of the catamenial pneumothorax patients who received adjuvant hormonal therapy after surgery had recurrence. A key limitation explicitly reflected by the cohort composition and treatment heterogeneity is that the study is small, retrospective, and based on clinical management without consensus guidelines, with uncertainty in generalizability. This paper is centrally about endometriosis — specifically thoracic endometriosis presenting as catamenial hemoptysis or catamenial pneumothorax, which directly relates to the broader endometriosis spectrum.

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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.

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endometriosisthoracic_endometriosis

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