Next Article in Journal
A Simple Physical Examination Predicts Cognitive Decline in Very Mild Dementia
Previous Article in Journal
Ultrasound-Guided Axillary Access Using a Micropuncture Needle Versus Conventional Cephalic Venous Access for Implantation of Cardiac Devices: A Single-Center Randomized Trial
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JPM
Volume 14
Issue 11
10.3390/jpm14111085
jpm-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Systematic Review

Pulmonary Endometriosis: A Systematic Review

by
Konstantinos Nikolettos
1,†,
Alexandros Patsouras
2,†,
Sonia Kotanidou
1,
Nikolaos Garmpis
3,4,
Iason Psilopatis
5,
Anna Garmpi
6,
Eleni I. Effraimidou
7,
Angelos Daniilidis
8,
Dimitrios Dimitroulis
9,
Nikos Nikolettos
1,
Panagiotis Tsikouras
1,
Angeliki Gerede
1,
Dimitrios Papoutsas
3,
Emmanuel Kontomanolis
1 and
Christos Damaskos
4,10,*
1
Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece
2
Second Department of Pulmonology, Sotiria General Hospital, 11527 Athens, Greece
3
Department of Surgery, Sotiria General Hospital, 11527 Athens, Greece
4
N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
5
Department of Obstetrics and Gynecology, University Erlangen Hospital, 91054 Erlangen, Germany
6
First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
7
First Surgical Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece
8
First University Department in Obstetrics and Gynecology, Papageorgiou General Hospital, School of Medicine, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
9
Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
10
Department of Emergency Surgery, Laiko General Hospital, 11527 Athens, Greece
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Pers. Med. 2024, 14(11), 1085; https://doi.org/10.3390/jpm14111085
Submission received: 17 August 2024 / Revised: 30 September 2024 / Accepted: 16 October 2024 / Published: 31 October 2024
(This article belongs to the Special Issue Gynecologic Oncology: From Molecular Mechanisms to Personalized Treatment)
Browse Figure
Versions Notes

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.

1. Introduction

Endometriosis is a chronic inflammatory process which affects approximately 10% of women of reproductive age [1]. It is defined by the presence of both endometrial-like stroma and glands outside the endometrial cavity [2]. Most lesions are located in the pelvis or the abdomen, and thus mainly cause pelvic pain, infertility, and uterine bleeding [1].
Thoracic endometriosis syndrome (TES) is a less frequent clinical entity. Due to the diverse symptoms of TES the exact incidence is challenging to establish. Studies suggest that 1.5% of the population have thoracic involvement of endometriosis [1]. The diaphragm, pleural cavity, and pulmonary parenchyma are affected by these lesions. TES is defined by four clinical entities, which include catamenial hemothorax (CHt), catamenial hemoptysis (CH), catamenial pneumothorax (CP), and lung nodules [3]. CH constitutes a rare entity which is characterized by recurrent hemoptysis during menstruation. The presence of endometrial tissue in the lung parenchyma or bronchus is regarded as the primary cause of this symptom. The pathophysiological mechanisms of intrabronchial or parenchymatic endometrial lesions still remain unclear. Additionally, there is no agreement on the characteristic clinical features or the ideal therapeutic alternatives for patients with lung endometriosis [3].
The aim of the current study is to present the total number of case reports presented in the international bibliography of thoracic endometriosis, and to evaluate their epidemiological features, symptoms, diagnostic methods, treatment procedures, and outcomes.

2. Materials and Methods

A review of the literature was conducted using the PubMed database to identify articles of case reports and case series of thoracic endometriosis. This systematic review was created in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines). All the articles published between January 1950 and March 2024 that met the inclusion criteria were accumulated in this systematic review. Specifically, our research was performed using keywords, separately and in various combinations, such as lung, pulmonary, thoracic endometriosis, TES, catamenial, hemothorax, hemoptysis, and pneumothorax. This study has not been registered in any public registry.
This systematic review includes patients diagnosed with thoracic endometriosis based on clinical or pathological findings, without specific consideration of the diagnostic methods used. Data from each publication on thoracic endometriosis were extracted and summarized based on the symptoms, the imaging methods utilized and their findings, smoking status, history of pelvic endometriosis, prior gynecological procedures, therapeutic approaches, and any reported recurrences.
The initial research using the aforementioned keywords identified 895 articles. After the removal of duplicates, 885 remained, and by filtering by case reports and case series, 444 studies remained. Furthermore, we checked the references from all articles found, aiming to include any other eligible studies. The remaining articles were screened and 242 were excluded for various reasons, such as irrelevant topics regarding the diagnosis of the case report, insufficient data, or the type of the article (e.g., abstract or review). Publications in non-English languages were also excluded. There were 202 full-text articles assessed for eligibility and none of them were excluded.

Risk of Bias

To minimize the bias risk of the systematic review of case reports and series, we predefined the inclusion and exclusion criteria as outlined previously.
Initially, the bibliography was assembled based on title and abstract by one author, and the full text screening was performed by another author. Two different authors performed the data extraction from the articles that met the inclusion criteria. Data about the age, symptoms, diagnostic methods, radiological findings, history of pelvic endometriosis and surgical history, treatment procedures, and recurrency rates in each article included were exported to an MS Excel spreadsheet to collect the same information. Two independent reviewers performed double data extraction to reduce the risk of bias assessments, and any disagreements were resolved by a third reviewer.
Some of the limitations manifested in this review are the exclusion of non-English language articles and the inconsistency of some common points among the studies included.
The inclusion process is shown in Figure 1 (PRISMA flow diagram).

3. Results

A total of 592 patients with thoracic endometriosis in 202 studies were reported and are listed below. Their main characteristics are reported in Table 1, Table 2, Table 3, Table 4, Table 5, Table 6 and Table 7. Their median age was 33.8 years old at presentation, and the most common symptom was pneumothorax (68.4%, 405/592), followed by chest pain (22%, 130/592), dyspnea (20.9%, 124/592), and hemoptysis (14.2%, 84/592). Cough as the main symptom was reported in 6.8% (40/592) of cases and pelvic pain, as a unique symptom, was presented in 2.4% (14/592). Other rare presentations were flu-like symptoms (4/592), shock state (1/592), or absence of symptoms (2/592). The presentation of the symptoms related to thoracic endometriosis is illustrated in Table 1.
In total, 35.3% of the included patients (47/133) were smokers, whereas 6% (8/133) were ex-smokers, and 58.6% (78/133) did not exhibit smoking habits. There is no information concerning smoking in the remaining 460 cases (77.5% of the total patients) (Table 2).
The location of each lesion was determined by radiological, endoscopic, or pathological methods. Most of the lesions (473/592, 79.9%) were found on the right side unilaterally, and specific ectopic endometrial lesions were encountered in 7.6% of the patients in the right lower lobe (RLL) (36/473), in 9.5% of them in the right upper lobe (RUL) (45/473), and in 2.7% in the right middle lobe (RML) (13/473) when mentioned. The lesions, which were only left-sided, were found in 7.9% of the patients (47/592). Lesions in the left upper lobe (LUL), including the lingula, and in the left lower lobe (LLL), were found in 59.6% (28/47) and in 34% (16/47) of patients, respectively. Bilateral lesions were found in 4.9% (29/592). In four patients, the lesions were observed in the trachea [129,130,131,194], whereas in another one, the location was not stated [109]. Extra-thoracic endometriosis was only detected in 47.8% of the cases (222/464). Table 3 and Table 4 summarize the location of the lesions.
On the contrary, 52.2% (242/464) of patients did not show any signs of extra-thoracic endometriosis, and in 21.5% of the total number of patients (127/592), no statement was made in the article (Table 5). The diagnostic tool (transvaginal ultrasonography, MRI, or exploratory laparoscopy) used to identify extra-thoracic endometriosis is not specified for each case.
As far as gynecological history is concerned, almost the half of the patients that mentioned their surgical history (53.5%, 212/396) had previously undergone gynecological procedures, including abortions (13.2%, 28/212), diagnostic laparoscopies (23.7%, 50/211), hysterectomies with or without oophorectomies (16.4%, 18/110), and cesarian sections (8.5%, 18/211). Many patients (31.1%, 184/592) had no history of any gynecological surgery in the past, while for the rest, 33.3% (197/592) of the patients, there is no information about their surgical history. Additional information is provided in Table 6 and Table 7.
The imaging methods used for diagnosis were chest X-ray, chest Computer Tomography (CT), chest Magnetic Resonance Imaging (MRI), and bronchoscopy. Chest X-rays were initially used in 189 out of 592 patients (31.9%). The most frequent finding in X-rays was pneumothorax (38%, 72/189), followed by normal findings (20.1%, 38/189), pleural effusion (13.8%, 26/189), consolidation (12.2%, 23/189), and nodules (9%, 17/189). Chest CT scans were most frequently conducted upon clinical symptomatology and at the beginning of the menstrual cycle (32.9%, 195/592). Ground-glass opacities (GGOs) were the most common radiological findings (21.5%, 42/195). Nodules and consolidation were found in 17.9% (35/195) and 10.8% (21/195), respectively. Cystic lesions including cavitary lesions and bullae were found in 15.4% (30/195). Pneumothorax was not so frequently encountered (10.3%, 20/195). Other rare findings included peribronchial infiltrates (2.1%, 4/195), normal findings (5.6%, 11/195), and ring-shaped lesions in only one patient. An absence of pathological findings and disappearance or reduction in the size of the lesions was frequently found in the middle of the menses. MRI and Positron Emission Tomography (PET) were only used in 14 (2.4%) [4,5,6,72,73,74,75,76,77,78,79,110,132,133] and 4 (0.7%) [7,134,135,186] cases, respectively, in order to confirm the exact position and nature of the lesions. Furthermore, bronchoscopies during symptoms were used for diagnosis in 66 out of 592 cases (11.1%). Hemorrhage or hyperemia was observed in 40.9% (27/66) of cases, whereas normal findings were noticed in 42.4% (28/66). Macroscopic lesions were noticed in 11 cases (16.7%), which constituted endobronchial endometriosis. The bronchoscopical lesions disappeared or diminished in size in 14 cases [136,137,138,139,140,187,194,195]. Finally, bronchial angiography was used in five cases (0.8%) in order to detect the site of the hemorrhage [109,111,130,141,142]. The main radiological findings are reported in Table 8, Table 9 and Table 10.
Diagnosis of endometriosis was either clinical or pathological. In total, 24.3% (144/592) of cases were histopathologically diagnosed by the presence of endometrial cells or glands. Another pathological finding was the simultaneous presence of endometrial glands, stroma, and hemosiderin-laden macrophages, which occurred in 61 cases (10.3%). Antibodies against CD-10, estrogen, or progesterone receptors were used effectively to diagnose pulmonary endometriosis in 84 cases (14.2%). The pathologist’s confirmation was derived from specimens obtained after surgery or bronchoscopy. Histopathological confirmation was derived by the use of bronchoscopy, by the use of bronchial washing or lavage, in six cases (1%). The rest of the patients had a clinical diagnosis. Table 11 summarizes the aforementioned findings.
The remaining cases (42.9%, 254/592) were diagnosed based on their clinical presentation with the assistance of radiographic techniques, as mentioned above. The correlation of the radiographic findings with the menses of women aids in the diagnosis of TES.
Thoracic surgical treatment was performed in 276 cases (46.6%). In total, 79.3% (219/276) of these operations were supported by video-assisted thoracoscopy (VATS), while in three cases robotic-assisted thoracoscopy (RATS) was performed. In the majority of cases, lobectomies, segmentectomies, and wedge resections were performed. In 34.4% (95/276), surgeons performed thoracotomies, whereas pleurectomy was performed in 38 patients. In 10 cases, the patients also underwent hysterectomy and bilateral oophorectomy (3.6%), and in thirty-nine cases (14.1%) diagnostic laparoscopy was performed.
Out of a total of 220 patients who received hormonal therapy in combination with the surgical treatment (40.1%), fifty-nine experienced at least one episode of recurrence (26.8%). Patients who received only hormonal therapy (45/549) had a recurrency stated at 33.3% (15/45). Nine patients reported symptoms during hormonal therapy [4,8,9,80,81,82,135,142,143]. Women experienced recurrence after cessation of the drugs as a result of side effects or a desire for pregnancy in 14 cases [12,27,38,39,44,51,52,53,54,55,142,147,153,196]. The drugs administered to the women as monotherapy or supplementary to the surgical treatment were androgens (41/283, 14.5%), progestins (41/283, 14.5%), gonadotropin-releasing hormones (GnRH), analogues (98/283, 34.6%), and contraceptives (44/283, 15.5%). Fourteen patients did not receive any treatment, whereas in eight case reports the treatment was not mentioned [116,134,168,193].
Minimally invasive techniques were used in nine cases, including three cases of endobronchial laser use, five cases of bronchial artery embolization, and one case of endometrial lesion cryoablation. Three out of five patients treated with bronchial artery embolization had a recurrence, and one out of three patients who underwent endobronchial laser use recurrences. The patient treated with cryoablation showed no recurrence [196]. Fourteen patients initially underwent conservative treatment [87,88,137,144,145,146,147,186,188]. Eight of them (57.1%) [145,147,188] presented with symptom recurrences and were treated either hormonally [188] or surgically [188], or spontaneously recovered [145,147].
Information on all therapeutic strategies is shown in Table 12 and Table 13.

4. Discussion

Lung endometriosis predominantly affects women between the ages of 20 and 40. In the current systematic review, 202 studies involving 592 patients were included. All the women were of reproductive age, except for two women aged 74 years old, who were receiving exogenous hormones for osteoporosis, and a woman of 51 years old, who was on hormonal treatment due to a past history of breast cancer [13,14]. Two of the patients were pregnant during the diagnosis and the presentation of symptoms of TES [15,112].
The most common symptom by far is catamenial pneumothorax. The symptoms most related to pneumothorax are considered to be catamenial chest pain and dyspnea. Two possible mechanisms seem to be responsible for the development of pneumothorax in lung endometriosis: the rupture of intra-pulmonary blebs, and alveolar damage due to the check-valve mechanism derived from intrabronchial endometriosis or bronchiolar constriction, following excessive production of prostaglandin [208].
Another frequent clinical presentation of TES is catamenial hemoptysis. The cause of hemorrhage is probably an endometriotic implant, either inside a large bronchus or in the lung parenchyma [148]. It is worth mentioning that no massive hemoptysis was reported in any case. The severity of hemoptysis is probably influenced by the biological activity and size of the lesion [188]. However, there is little knowledge on this issue.
As far as the location is concerned, the majority of the implants are right-sided. This may support the theory of the transabdominal–transdiaphragmatic migration of endometrial cells through the right paracolic gutter. This theory requires the existence of passage in the diaphragm between the abdomen and the thorax [205]. Thus, this theory might explain the development of pleural, but not lung, endometriosis [16,17]. In addition, the lower lobes of the lungs seem to be more affected, which supports the theory of microembolization as the pathophysiologic mechanism of lung endometriosis [89,188,206]. Small endometrial tissues cause microemboli in the lung capillaries [149]. This happens as larger quantities of blood circulate in the lower lobes than in the upper ones [89,188].
Previous gynecological procedures might represent a risk factor for the development of this disease [113,150,188]. The most frequent operations were abortions, hysterectomies, and diagnostic laparoscopies. This can occur as a result of the lymphogenic or hematogenic migration of endometrial cells to the pulmonary parenchyma [150]. We should also highlight that the existence of pulmonary endometriosis is not always associated with abdominal or pelvic endometriosis. However, this does not mean that patients with pulmonary endometriosis should not be checked for other endometrial sites.
Most pathological findings reported endometrial glands, stroma, and hemosideren-laden macrophages. The use of other methods, including immunohistochemistry and anti-estrogen/progesterone receptor antibodies, can be helpful for diagnosis in the case of insufficient endometrial samples. Pseudoinfiltrative patterns without cytologic atypia or microscopic foci inside the bronchovascular bundles with signs of hemorrhage can be found in parenchymal lesions [13]. Endometrial cells can also be found after bronchial washing through bronchoscopy.
A range of diagnostic tests can aid in the differential diagnosis of TES. Beneficial tools include chest radiographs (CXR), CT scans, MRI, and bronchoscopy. The first radiologic examination was usually a chest X-ray. The most common finding in chest X-rays was pneumothorax, followed by consolidation probably due to hemorrhage and lung nodules. Pneumothorax was usually associated with chest pain and dyspnea. Chest CT was the most helpful imaging method for the location of lesions. The radiological findings included ground-glass opacities, consolidation due to hemorrhage, lung nodules, cystic lesions, and pneumothorax. The disappearance of CT lesions during the menstrual cycle favours thoracic endometriosis. MRI was used successfully in order to identify the exact location of the endometrial lesions. Bronchoscopy is not a suitable procedure for distal lesions, although it can reveal sites of hemorrhage [83,132,148,151]. Visible intrabronchial endometrial sites are reported in few cases, including purplish-red or brown submucosal patches in the airways [130,136,152,194]. Even though bronchoscopy cannot histologically confirm the diagnosis, the disappearance of the previous findings in bronchoscopies occurring in the middle of the menses should raise suspicion of endometriosis [140,142,187,195]. Finally, angiography was used in certain cases in order to confirm the exact site of hemorrhaging [109,111,130,141]. The typical findings were prominent vasculature and vascular stains in the absence of endometriosis-characteristic features [109].
The treatment of thoracic endometriosis includes several approaches. Surgical resection can be either used as first-line or second-line treatment after failure or adverse effects of hormone administration [141]. Video-assisted thoracoscopy and surgery are currently mostly used for the resection of endometrial lesions [18,72,114,153,154]. These include wedge resections and lobectomies. Exploratory thoracotomies and open surgeries can occur when VATS is not effective [19,197]. Surgeries can vary from parenchymal sparing to lobectomies [141,148]. Chest-tube placement is used in cases with life-threatening pneumothorax [17]. Minimally invasive, non-pharmacological treatments with satisfactory clinical outcomes are also reported in the literature. These include bronchoscopical ND-YAG laser treatment and cryoablation through CT guidance [89,152,196]. Bronchial artery embolization failed to treat the patient permanently [89]. The most effective treatment is hysterectomy with bilateral salpigo-oophorectomy [111,134,155]. However, this therapeutic approach should be limited in certain cases due to the multiple side effects of artificial menopause. However, there is a chance of recurrence if hormonal replacement treatment is administrated or partial oophorectomy has been conducted [3,13,148].
Hormone treatment has been used for the management of thoracic endometriosis. The aim of these drugs is to block the ovarian stimulation of the ectopic endometrial tissue [208]. Drugs including oral contraceptives, GnRH agonists, progestin analogs, and androgens have been effectively used for this purpose, as mentioned above. To date, no specific superiority of one drug over the others has been demonstrated, neither in terms of efficacy nor side effects. The drugs mostly used are GnRH analogues and combined oral contraceptives. GnRH agonists cause hypogonadotropic hypogonadism, since they reduce luteinizing and follicle-stimulating hormone [113]. Their side effects are a result of low levels of estrogen and progesterone. Oral combined contraceptives inhibit the secretion of GnRH, follicle-stimulating hormone (FSH), and luteinizing hormone [LH]. An androgen frequently used, danazol, leads to anovulation through an increase in blood testosterone and an inhibition of steroidogenesis, but might cause androgenetic side effects or liver damage [207]. Progestins influence the release of GnRH, leading to a decrease in the secretion of FSH and LH [209]. Hypoestrogenism causes the atrophy of ectopic endometrium. The most common side effects are weight gain, hypertension, uterine bleeding, depression, and breast tenderness [141,154,198]. However, hormonal therapy alone seems to be associated with a greater number of recurrences than surgical approaches, based on the data collected by the case reports and the series included in this systematic review. The recurrences are a result of the cessation of the drug due to side effects, and usually do not occur during administration periods [73,84,130,140,141,148,151]. In some cases, a more aggressive approach has been implemented, with both surgical and hormonal treatments (pro- or neo-adjuvant), in order to prevent recurrences and offer the best clinical outcome [18,114,154].
The administration of hormonal drugs renders pregnancy impossible and is associated with various side effects, as mentioned above [141]. Surgery can also have a variety of complications. Furthermore, some support that ectopic endometrial cells do not surely show similar behaviour to normal endometrial tissue towards hormonal influence [147]. No report for massive hemoptysis has ever been published. Thus, conservative treatment has been used as therapeutic approach in this disease. It has been demonstrated that women with mild symptoms show no recurrence of their symptoms without any therapeutic intervention [137,144]. Conservative treatment and follow-up can be a therapeutic approach for these women [147,188]. The ESHRE guidelines recommend the proposal of hormonal treatment in these cases, but if surgery is indicated, the involvement of a thoracic surgeon and/or other relevant specialists is suggested [2].
This review has some limitations: Articles in non-English languages were not included in this study. The use of case series and case reports provides knowledge about this disease. However, these articles do not share many common data points that can be used to extract safe conclusions concerning incidence or cause–effect. Finally, the follow-up periods are short in many studies.

5. Conclusions

It is obvious that pulmonary endometriosis is more frequent than thought. Its main clinical characteristic is catamenial hemoptysis, which coincides with the menstrual cycle of the woman. The radiological disappearance of the lesion in the middle of the woman’s cycle is another important point to mention. However, no specific guidelines exist concerning the diagnosis and therapeutic management of these patients. Thus, its prompt management requires a high level of clinical expertise and a multi-disciplinary approach. Finally, it is of paramount importance to create an international registry of patients with clear and common data points, in order to facilitate data extraction and acquire better knowledge of the disease.

Author Contributions

Conceptualization, C.D. and N.G.; data curation, K.N., A.P., S.K., N.G., I.P., A.G. (Anna Garmpi) and C.D.; writing—original draft preparation, K.N., A.P., S.K., N.G. and C.D.; writing—review and editing, E.I.E., A.D., D.D., N.N., P.T., A.G. (Angeliki Gerede), D.P., E.K. and C.D.; supervision, C.D. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

No new data were created or analyzed in this study. Data sharing is not applicable to this article.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Andres, M.P.; Arcoverde, F.V.L.; Souza, C.C.C.; Fernandes, L.F.C.; Abrão, M.S.; Kho, R.M. Extrapelvic Endometriosis: A Systematic Review. J. Minim. Invasive Gynecol. 2020, 27, 373–389. [Google Scholar] [CrossRef] [PubMed]
  2. Becker, C.M.; Bokor, A.; Heikinheimo, O.; Horne, A.; Jansen, F.; Kiesel, L.; King, K.; Kvaskoff, M.; Nap, A.; Petersen, K.; et al. ESHRE guideline: Endometriosis. Hum. Reprod. Open 2022, 2022, hoac009. [Google Scholar] [CrossRef] [PubMed]
  3. Joseph, J.; Sahn, S.A. Thoracic endometriosis syndrome: New observations from an analysis of 110 cases. Am. J. Med. 1996, 100, 164–170. [Google Scholar] [CrossRef] [PubMed]
  4. Parker, C.M.; Nolan, R.; Lougheed, M.D. Catamenial hemoptysis and pneumothorax in a patient with cystic fibrosis. Can. Respir. J. 2007, 14, 295–297. [Google Scholar] [CrossRef]
  5. Härkki, P.; Jokinen, J.J.; Salo, J.A.; Sihvo, E. Menstruation-related spontaneous pneumothorax and diaphragmatic endometriosis. Acta. Obstet. Gynecol. Scand. 2010, 89, 1192–1196. [Google Scholar] [CrossRef]
  6. Lameira, P.; Abecasis, M.; Palma, S.; Leitão, J. Catamenial pneumothorax: A rare manifestation of endometriosis. Radiol. Case Rep. 2022, 17, 3119–3125. [Google Scholar] [CrossRef]
  7. Giordano, T.; MacDonald, W. Thoracic endometriosis presenting as recurrent pleural effusions. Radiol. Case Rep. 2020, 16, 250–253. [Google Scholar] [CrossRef]
  8. Akal, M.; Kara, M. Nonsurgical treatment of a catamenial pneumothorax with a Gn-RH analogue. Respiration 2002, 69, 275–276. [Google Scholar] [CrossRef]
  9. Staring, G.; Monteiro, F.; Barracha, I.; Amorim, R. Multi-loculated catamenial pneumothorax: A rare complication of thoracic endometriosis. Cureus 2021, 13, e17583. [Google Scholar] [CrossRef]
  10. Karpel, J.P.; Appel, D.; Merav, A. Pulmonary endometriosis. Lung 1985, 163, 151–159. [Google Scholar] [CrossRef]
  11. Hirono, T.; Feng, Y.; Wang, W.; Yu, H. Spontaneous recurrent menstrual pneumothorax: A case report. Ann. Med. Surg. 2024, 86, 1096–1100. [Google Scholar] [CrossRef] [PubMed]
  12. Takahashi, R.; Kurihara, M.; Mizobuchi, T.; Ebana, H.; Yamanaka, S. Left-sided catamenial pneumothorax with thoracic endometriosis and bullae in the alveolar wall. Ann. Thorac. Cardiovasc. Surg. 2017, 23, 108–112. [Google Scholar] [CrossRef] [PubMed]
  13. Flieder, D.B.; Moran, C.A.; Travis, W.D.; Koss, M.N.; Mark, E.J. Pleuro-pulmonary endometriosis and pulmonary ectopic deciduosis: A clinicopathologic and immunohistochemical study of 10 cases with emphasis on diagnostic pitfalls. Hum. Pathol. 1998, 29, 1495–1503. [Google Scholar] [CrossRef] [PubMed]
  14. Yukumi, S.; Suzuki, H.; Morimoto, M.; Shigematsu, H.; Sugimoto, R.; Sakao, N.; Abe, M.; Watanabe, A.; Kitazawa, S.; Sano, Y. A case of thoracic endometriosis-related pneumothorax in a menopausal woman. Gen. Thorac. Cardiovasc. Surg. 2020, 68, 1584–1586. [Google Scholar] [CrossRef]
  15. Yoshioka, H.; Fukui, T.; Mori, S.; Usami, N.; Nagasaka, T.; Yokoi, K. Catamenial pneumothorax in a pregnant patient. Jpn. J. Thorac. Cardiovasc. Surg. 2005, 53, 280–282. [Google Scholar] [CrossRef]
  16. Van Schil, P.E.; Vercauteren, S.R.; Vermeire, P.A.; Nackaerts, Y.H.; Van Marck, E.A. Catamenial pneumothorax caused by thoracic endometriosis. Ann. Thorac. Surg. 1996, 62, 585–586. [Google Scholar] [CrossRef]
  17. Morcos, M.; Alifano, M.; Gompel, A.; Regnard, J.F. Life-threatening endometriosis-related hemopneumothorax. Ann. Thorac. Surg. 2006, 82, 726–729. [Google Scholar] [CrossRef]
  18. Sakai, T.; Azuma, Y.; Sano, A.; Tochigi, N.; Iyoda, A. Catamenial pneumothorax with pulmonary fistula identified during surgery. Ann. Thorac. Surg. 2020, 110, e209–e211. [Google Scholar] [CrossRef]
  19. Ucvet, A.; Sirzai, E.Y.; Yakut, F.C.; Yoldas, B.; Gursoy, S. Thoracic pulmonary endometriosis: Two reports of a rare disease. Arch. Bronconeumol. 2014, 50, 454–455. [Google Scholar] [CrossRef]
  20. Arunthari, V.; Sevin, B.U.; Krishna, M.; Johnson, M.M. Catamenial pneumothorax with umbilical and diaphragmatic endometriosis: A case report and review of the literature. South Med. J. 2008, 101, 1043–1045. [Google Scholar] [CrossRef]
  21. Albores, J.; Fishbein, G.; Bando, J. A 34-year-old woman with recurrent right-sided chest pain and dyspnea. Chest 2015, 148, e148–e151. [Google Scholar] [CrossRef] [PubMed]
  22. Scarnecchia, E.; Inzirillo, F.; Declich, P.; Della Pona, C. Thoracic endometriosis-related non-catamenial pneumothorax with peculiar histological findings. Gen. Thorac. Cardiovasc. Surg. 2020, 68, 1040–1042. [Google Scholar] [CrossRef] [PubMed]
  23. Yukumi, S.; Suzuki, H.; Morimoto, M.; Shigematsu, H.; Okazaki, M.; Abe, M.; Kitazawa, S.; Nakamura, K.; Sano, Y. Two young women with left-sided pneumothorax due to thoracic endometriosis. Intern. Med. 2016, 55, 3491–3493. [Google Scholar] [CrossRef] [PubMed]
  24. Kovarik, J.L.; Toll, G.D. Thoracic endometriosis with recurrent spontaneous pneumothorax. JAMA 1966, 196, 595–597. [Google Scholar] [CrossRef]
  25. Aissa, S.; Benzarti, W.; Alimi, F.; Gargouri, I.; Salem, H.B.; Aissa, A.; Fathallah, K.; Abdelkade, A.B.; Alouini, R.; Garrouche, A.; et al. Catamenial pneumothorax revealing diaphragmatic endometriosis: A case report and revue of literature. Pan Afr. Med. J. 2017, 27, 112. [Google Scholar] [CrossRef]
  26. Devue, K.; Coenye, K.; Verhaeghe, W. A case of catamenial pneumothorax caused by thoracic endometriosis. Eur. J. Emerg. Med. 2005, 12, 92–94. [Google Scholar] [CrossRef]
  27. Cieslik, L.; Haider, S.S.; Fisal, L.; Rahmaan, J.A.A.; Sachithanandan, A. Minimally invasive thoracoscopic mesh repair of diaphragmatic fenestrations for catamenial pneumothorax due to likely thoracic endometriosis: A case report. Med. J. Malays. 2013, 68, 366–367. [Google Scholar]
  28. Guenther, T.M.; Gustafson, J.D.; Pribyl, S.M.; Wozniak, C.J. Recurrent spontaneous pneumothorax in a 47-year-old woman. Mil. Med. 2020, 185, e1833–e1835. [Google Scholar] [CrossRef]
  29. Shiraishi, T. Catamenial pneumothorax: Report of a case and review of the Japanese and non-Japanese literature. Thorac. Cardiovasc. Surg. 1991, 39, 304–307. [Google Scholar] [CrossRef]
  30. Korom, S.; Canyurt, H.; Missbach, A.; Schneiter, D.; Kurrer, M.O.; Haller, U.; Keller, P.J.; Furrer, M.; Weder, W. Catamenial pneumothorax revisited: Clinical approach and systematic review of the literature. J. Thorac. Cardiovasc. Surg. 2004, 128, 502–508. [Google Scholar] [CrossRef]
  31. Ichiki, Y.; Nagashima, A.; Yasuda, M.; Takenoyama, M.; Toyoshima, S. Surgical treatment of catamenial pneumothorax: Report of three cases. Asian J. Surg. 2015, 38, 180–185. [Google Scholar] [CrossRef] [PubMed]
  32. Visouli, A.N.; Darwiche, K.; Mpakas, A.; Zarogoulidis, P.; Papagiannis, A.; Tsakiridis, K.; Machairiotis, N.; Stylianaki, A.; Katsikogiannis, N.; Courcoutsakis, N.; et al. Catamenial pneumothorax: A rare entity? Report of 5 cases and review of the literature. J. Thorac. Dis. 2012, 4, 17–31. [Google Scholar] [CrossRef] [PubMed]
  33. Kardaman, N.; Nizami, M.; Marciniak, S.; Hogan, J.; Aresu, G. Catamenial pneumothorax. Ann. R. Coll. Surg. Engl. 2022, 104, e109–e112. [Google Scholar] [CrossRef] [PubMed]
  34. Koike, S.; Kobayashi, N.; Miyazawa, M. Positive outcome of diaphragm covering and total pleural covering techniques for catamenial pneumothorax. J. Surg. Case. Rep. 2023, 2023, rjad421. [Google Scholar] [CrossRef]
  35. Duyos, I.; López-Carrasco, A.; Hernández, A.; Zapardiel, I.; De Santiago, J. Management of thoracic endometriosis: Single institution experience. Eur. J. Obstet. Gynecol. Reprod. Biol. 2014, 178, 56–59. [Google Scholar] [CrossRef]
  36. Poh, C.L.; Yan, T.D.; Vallely, M.P.; Bannon, P.G.; Mccaughan, B.C. Pulmonary parenchymal endometriosis presenting as bilateral pneumothoraces. J. Obstet. Gynaecol. 2011, 31, 452–453. [Google Scholar] [CrossRef]
  37. Fang, H.Y.; Jan, C.I.; Chen, C.K.; Chen, W.T. Catamenial pneumothorax due to bilateral pulmonary endometriosis. Respir. Care 2012, 57, 1182–1185. [Google Scholar] [CrossRef]
  38. Low, Q.J.; Cheo, S.W.; Wong, W.H.; Goh, K.S. Endometriosis—A rare cause of primary spontaneous pneumothorax. Med. J. Malays. 2019, 74, 445–446. [Google Scholar]
  39. Papafragaki, D.; Concannon, L. Catamenial pneumothorax: A case report and review of the literature. J. Womens Health 2008, 17, 367–372. [Google Scholar] [CrossRef]
  40. Oger, P.; Alifano, M.; Regnard, J.F.; Gompel, A. Difficult management of recurrent catamenial pneumothorax. Gynecol. Endocrinol. 2006, 22, 713–715. [Google Scholar] [CrossRef]
  41. Azizad-Pinto, P.; Clarke, D. Thoracic endometriosis syndrome: Case report and review of the literature. Perm. J. 2014, 18, 61–65. [Google Scholar] [CrossRef] [PubMed]
  42. Lua, L.L.; Tran, K.; Desai, J. Refractory thoracic endometriosis syndrome with bilateral hemothorax. J. Obstet. Gynaecol. Res. 2017, 43, 1227–1231. [Google Scholar] [CrossRef] [PubMed]
  43. Nemeş, R.M.; Paleru, C.; Dănăilă, O.; Ianoşi, E.S.; Pop, C.S.; DiŢescu, D.; Streba, C.T.; NiŢu, M.F. Thoracic endometriosis with a long delay in diagnosis. Rom. J. Morphol. Embryol. 2015, 56, 295–300. [Google Scholar] [PubMed]
  44. Ziedalski, T.M.; Sankaranarayanan, V.; Chitkara, R.K. Thoracic endometriosis: A case report and literature review. J. Thorac. Cardiovasc. Surg. 2004, 127, 1513–1514. [Google Scholar] [CrossRef]
  45. McCann, M.R.; Schenk, W.B.; Nassar, A.; Maimone, S. Thoracic endometriosis presenting as a catamenial hemothorax with discordant video-assisted thoracoscopic surgery. Radiol. Case Rep. 2020, 15, 1419–1422. [Google Scholar] [CrossRef]
  46. Dhanaworavibul, K.; Hanprasertpong, J.; Cheewadhanaraks, S.; Buhachat, R. Bilateral pleural endometriosis. J. Obstet. Gynaecol. Res. 2006, 32, 86–89. [Google Scholar] [CrossRef]
  47. Ismail, Y.; Kamaruzzaman, A. Thoracic endometriosis: A report of two cases. Med. J. Malays. 2004, 59, 279–280. [Google Scholar]
  48. Junejo, S.Z.; Lubana, S.S.; Shina, S.S.; Tuli, S.S. A case of thoracic endometriosis syndrome presenting with recurrent catamenial pneumothorax. Am. J. Case Rep. 2018, 19, 573–576. [Google Scholar] [CrossRef]
  49. Aguilar-Shea, A.L.; Gallardo-Mayo, C. Thoracic endometriosis as cause of recurrent pneumothorax. QJM Int. J. Med. 2012, 105, 1205–1207. [Google Scholar] [CrossRef]
  50. Tsunezuka, Y.; Sato, H.; Kodama, T.; Shimizu, H.; Kurumaya, H. Expression of CA125 in thoracic endometriosis in a patient with catamenial pneumothorax. Respiration 2012, 66, 470–472. [Google Scholar] [CrossRef]
  51. Inam, H.; Inam, S.; Tahir, M. Catamenial pneumothorax: A case report. J. Pak. Med. Assoc. 2016, 66, 1327–1329. [Google Scholar]
  52. Baisi, A.; Raveglia, F.; Simone, M.D.; Calati, A.M.; Leporati, A.; Cioffi, U. Endometriosis-related pneumothorax after in vitro fertilization embryo transfer procedure: A case report. J. Thorac. Cardiovasc. Surg. 2020, 139, e88–e89. [Google Scholar] [CrossRef]
  53. Alifano, M.; Cancellieri, A.; Fornelli, A.; Trisolini, R.; Boaron, M. Endometriosis-related pneumothorax: Clinicopathologic observations from a newly diagnosed case. J. Thorac. Cardiovasc. Surg. 2004, 127, 1219–1221. [Google Scholar] [CrossRef]
  54. Yamazaki, S.; Ogawa, J.; Koide, S.; Shohzu, A.; Osamura, Y. Catamenial pneumothorax associated with endometriosis of the diaphragm. Chest 1980, 77, 107–109. [Google Scholar] [CrossRef]
  55. Garg, V.; McKenzie Gray, B. An unusual case of catamenial pneumothorax. J. Obstet. Gynaecol. 2008, 28, 354–355. [Google Scholar] [CrossRef]
  56. Maurer, E.R.; Schaal, J.A.; Mendez, F.L., Jr. Chronic recurring spontaneous pneumothorax due to endometriosis of the diaphragm. J. Am. Med. Assoc. 1958, 168, 2013–2014. [Google Scholar] [CrossRef]
  57. Bagan, P.; Le Pimpec Barthes, F.; Assouad, J.; Souilamas, R.; Riquet, M. Catamenial pneumothorax: Retrospective study of surgical treatment. Ann. Thorac. Surg. 2003, 75, 378–381, Discussion 381. [Google Scholar] [CrossRef]
  58. Grunewald, R.A.; Wiggins, J. Pulmonary endometriosis mimicking an acute abdomen. Postgrad. Med. J. 1988, 64, 865–866. [Google Scholar] [CrossRef]
  59. Davies, R. Recurring spontaneous pneumothorax concomitant with menstruation. Thorax 1968, 23, 370–373. [Google Scholar] [CrossRef]
  60. Poyraz, A.S.; Kilic, D.; Hatipoglu, A.; Demirhan, B.A. A very rare entity: Catamenial pneumothorax. Asian Cardiovasc. Thorac. Ann. 2005, 13, 271–273. [Google Scholar] [CrossRef]
  61. Mukku, V.K.; Cassidy, E.; Negulescu, C.; Jagneaux, T.; Godke, J. Large spontaneous right catamenial pneumothorax with diaphragmatic defect and liver herniation. Case Rep. Pulmonol. 2019, 2019, 8436450. [Google Scholar] [CrossRef]
  62. Uemura, T.; Matsuyama, A.; Minaguchi, H.; Ikeda, H. Danazol (an antigonadotropin) in the treatment of catamenial pneumothorax. Asia Oceania J. Obstet. Gynaecol. 1958, 11, 81–86. [Google Scholar] [CrossRef]
  63. Sharma, N.; Todhe, P.; Ochieng, P.; Ramakrishna, S. Refractory thoracic endometriosis. BMJ Case Rep. 2020, 13, e235965. [Google Scholar] [CrossRef]
  64. El Haj Chehade, A.; Nasir, A.B.; Peterson, J.E.G.; Ramseyer, T.; Bhardwaj, H. Thoracic endometriosis presenting as hemopneumothorax. Monaldi Arch. Chest. Dis. 2022, 93, 2022. [Google Scholar] [CrossRef]
  65. Dong, B.; Wu, C.L.; Sheng, Y.L.; Wu, B.; Ye, G.C.; Liu, Y.F.; Li, S.H.; Han, L.; Qi, Y. Catamenial pneumothorax with bubbling up on the diaphragmatic defects: A case report. BMC Womens Health 2021, 21, 167. [Google Scholar] [CrossRef]
  66. Miedziarek, C.; Kasprzyk, M. Catamenial pneumothorax—Are there benefits of cooperation between the surgeon and the gynaecologist? Prz. Menopauzalny 2022, 21, 69–72. [Google Scholar] [CrossRef]
  67. Gupta, V.; Noh, K.W.; Maschek, H.; Thal, S.; Welter, S. A unique case of thoracic endometriosis syndrome and pulmonary Langerhans’ cell histiocytosis: Six recurrent pneumothoraces. Respir. Med. Case Rep. 2022, 36, 101603. [Google Scholar] [CrossRef]
  68. Mikroulis, D.A.; Didilis, V.N.; Konstantinou, F.; Vretzakis, G.H.; Bougioukas, G.I. Catamenial pneumothorax. Thorac. Cardiovasc. Surg. 2008, 56, 374–375. [Google Scholar] [CrossRef]
  69. Solanki, K.K.; Shook, M.; Yorke, J.; Vanlandingham, A. A rare case of catamenial pneumothorax and a review of the current literature. Cureus 2023, 15, e42006. [Google Scholar] [CrossRef]
  70. Pratomo, I.P.; Putra, M.A.; Bangun, L.G.; Soetartio, I.M.; Maharani, M.A.P.; Febriana, I.S.; Soehardiman, D.; Prasenohadi, P.; Kinasih, T. Video-assisted surgical diagnosis and pleural adhesion management in catamenial pneumothorax: A case and literature review. Respirol. Case Rep. 2023, 11, e01123. [Google Scholar] [CrossRef]
  71. Das Posses Bridi, G.; de Oliveira, M.R.; Carvalho, C.R.R.; do Nascimento, E.C.T.; Baldi, B.G. Thoracic endometriosis presenting as diffuse cystic lung disease: A rare case report. Pulmonology 2024, 30, 195–197. [Google Scholar] [CrossRef]
  72. Maniglio, P.; Ricciardi, E.; Meli, F.; Vitale, S.G.; Noventa, M.; Vitagliano, A.; Valenti, G.; La Rosa, V.L.; Laganà, A.S.; Caserta, D. Catamenial pneumothorax caused by thoracic endometriosis. Radiol. Case Rep. 2017, 13, 81–85. [Google Scholar] [CrossRef]
  73. Matalliotakis, I.M.; Goumenou, A.G.; Koumantakis, G.E.; Neonaki, M.A.; Koumantakis, E.E.; Arici, A. Pulmonary endometriosis in a patient with unicornuate uterus and noncommunicating rudimentary horn. Fertil. Steril. 2002, 78, 183–185. [Google Scholar] [CrossRef]
  74. Zhu, C.R.; Suen, M.W.H.; Gilbert, S.; Singh, S.S. Laparoscopic management of diaphragmatic endometriosis. J. Obstet. Gynaecol. Can. 2019, 41, 741. [Google Scholar] [CrossRef]
  75. Gaichies, L.; Blouet, M.; Comoz, F.; Foulon, A.; Heyndrickx, M.; Fauvet, R. Non-traumatic diaphragmatic rupture with liver herniation due to endometriosis: A rare evolution of the disease requiring multidisciplinary management. J. Gynecol. Obstet. Hum. Reprod. 2019, 48, 785–788. [Google Scholar] [CrossRef]
  76. Blanco, S.; Hernando, F.; Gómez, A.; González, M.J.; Torres, A.J.; Balibrea, J.L. Catamenial pneumothorax caused by diaphragmatic endometriosis. J. Thorac. Cardiovasc. Surg. 1998, 116, 179–180. [Google Scholar] [CrossRef]
  77. Picozzi, G.; Beccani, D.; Innocenti, F.; Grazzini, M.; Mascalchi, M. MRI features of pleural endometriosis after catamenial haemothorax. Thorax 2007, 62, 744. [Google Scholar] [CrossRef]
  78. Gilabert-Estelles, J.; Zorio, E.; Castello, J.M.; Estelles, A.; Gilabert-Aguilar, J. Laparoscopic approach to right diaphragmatic endometriosis with argon laser: Case report. J. Minim. Invasive Gynecol. 2020, 17, 124–127. [Google Scholar] [CrossRef]
  79. Jacob, A.; Coker, A.; Stamenkovic, S.A. Robotic-assisted thoracic surgery approach to thoracic endometriosis syndrome with unilateral diaphragmatic palsy. Case. Rep. Surg. 2023, 2023, 5493232. [Google Scholar] [CrossRef]
  80. Trehan, K.; Mungo, B.; Molena, D. Recurrent thoracic endometriosis with extensive adhesions after talc pleurodesis. Surgery 2015, 158, 1740–1741. [Google Scholar] [CrossRef]
  81. Morita, Y.; Tsutsumi, O.; Taketani, Y. Successful hormonal treatment of pulmonary parenchymal endometriosis. Int. J. Gynecol. Obstet. 1997, 59, 61–63. [Google Scholar] [CrossRef] [PubMed]
  82. Ezemba, N.; Okafor, O.C.; Emeruem, N.U.; Adiri, C.O. Thoracic endometriosis syndrome in Nigeria: A single-centre experience. Interact. Cardiovasc. Thorac. Surg. 2021, 32, 256–262. [Google Scholar] [CrossRef] [PubMed]
  83. Elliot, D.L.; Barker, A.F.; Dixon, L.M. Catamenial hemoptysis. Chest 1958, 87, 687–688. [Google Scholar] [CrossRef] [PubMed]
  84. Keating, E.; Lawson, R.A.; Li, T.C.; Makris, M. Monthly haemoptysis in a woman with platelet storage pool disease. Clin. Lab. Haematol. 2000, 22, 295–296. [Google Scholar] [CrossRef]
  85. Leonardo-Pinto, J.P.; Benetti-Pinto, C.L.; Quagliato, I.; Yela, D.A. Hemoptysis and endometriosis: An unusual association—Case report and review of the literature. Rev. Bras. Ginecol. Obstet. 2018, 40, 300–303. [Google Scholar] [CrossRef]
  86. Marshall, M.B.; Ahmed, Z.; Kucharczuk, J.C.; Kaiser, L.R.; Shrager, J.B. Catamenial pneumothorax: Optimal hormonal and surgical management. Eur. J. Cardiothorac. Surg. 2005, 27, 662–666. [Google Scholar] [CrossRef]
  87. Ogunkoya, J.O.; Solaja, T.O.; Ogunlade, A.F.; Ogunmola, M.I. Thoracic endometriosis: A presentation of an uncommon disease in a black African woman. Case Rep. Med. 2022, 2022, 2380700. [Google Scholar] [CrossRef]
  88. Sturney, S.C.; Meecham-Jones, J.; White, A. An uncommon case of hydropneumothorax and haemoptysis. BMJ Case Rep. 2013, 2013, bcr2013200. [Google Scholar] [CrossRef]
  89. Kervancioglu, S.; Andic, C.; Bayram, N.; Telli, C.; Sarica, A.; Sirikci, A. Bronchial artery embolization in the management of pulmonary parenchymal endometriosis with hemoptysis. Cardiovasc. Interv. Radiol. 2008, 31, 824–827. [Google Scholar] [CrossRef]
  90. Nezhat, C.; Main, J.; Paka, C.; Nezhat, A.; Beygui, R.E. Multidisciplinary treatment for thoracic and abdominopelvic endometriosis. J. Soc. Laparosc. Robot. Surg. 2014, 18, e2014.00312. [Google Scholar] [CrossRef]
  91. Rawala, M.S.; Khaliq, M.F.; Iqbal, M.A.; Naqvi, S.T.S.; Farhan, K.; Myers, A.; Helmick, K. A rare case of cyclical hemothorax: Thoracic endometriosis syndrome. Case Rep. Pulmonol. 2018, 2018, 9830797. [Google Scholar] [CrossRef] [PubMed]
  92. Adesanya, O.A.; Kolawole, O.E. Thoracic endometriosis syndrome: Cutting the gordian knot—A case report and review of the literature. Int. J. Surg. Case Rep. 2020, 66, 68–71. [Google Scholar] [CrossRef]
  93. Rychlik, D.F.; Bieber, E.J. Thoracic endometriosis syndrome resembling pulmonary embolism. J. Am. Assoc. Gynecol. Laparosc. 2001, 8, 445–448. [Google Scholar] [CrossRef] [PubMed]
  94. Byanyima, R.K. Menstruation in an unsual place: A case of thoracic endometriosis in Kampala, Uganda. Afr. Health Sci. 2001, 1, 97–98. [Google Scholar] [PubMed]
  95. Moffatt, S.D.; Mitchell, J.D. Massive pleural endometriosis. Eur. J. Cardiothorac. Surg. 2002, 22, 321–323. [Google Scholar] [CrossRef]
  96. Nizami, M.; Mani, A.; Begum, S. Catamenial hemothorax: A rare case of thoracic endometriosis. Ann. Thorac. Surg. 2019, 108, e127. [Google Scholar] [CrossRef]
  97. Dogra, N.; Luthra, A.; Chauhan, R.; Bajaj, R.; Gourav, K.P. Recurrent unilateral hemorrhagic pleural effusion: A rare manifestation of thoracic endometriosis syndrome. Ann. Card. Anaesth. 2020, 23, 521–523. [Google Scholar] [CrossRef]
  98. Kyo, S.; Takakura, M.; Nishida, S.; Ozaki, S.; Oda, M.; Inoue, M. Massive hemothorax due to diaphragmatic endometriosis after a laparoscopic cystectomy of an ovarian endometrioma in a patient without a history of thoracic endometriosis. Arch. Gynecol. Obstet. 2012, 286, 411–414. [Google Scholar] [CrossRef]
  99. Somani, A.; Pillai, S.; Maryam, M.; Chakrapani, A. A rare massive presentation of catamenial hemothorax. Am. J. Emerg. Med. 2020, 38, 1695.e1–1695.e3. [Google Scholar] [CrossRef]
  100. Davis, B.M.; Goldstraw, E.; Bhowmik, A.; José, R.J. A gynaecological cause of spontaneous haemopneumothorax. Br. J. Hosp. Med. 2016, 77, 602–603. [Google Scholar] [CrossRef]
  101. Arakawa, S.; Matsudaira, H.; Noda, Y.; Yamashita, M.; Hirano, J.; Ogawa, M.; Ohtsuka, T. Catamenial pneumothorax with partial liver herniation due to diaphragmatic laceration: A case report and literature review. J. Cardiothorac. Surg. 2021, 16, 23. [Google Scholar] [CrossRef] [PubMed]
  102. Yildirim, M.; Oztekin, O.; Oztekin, D. Recurrent chest pain, as a presenting sign of ovarian endometrioma. ISRN Surg. 2011, 2011, 837501. [Google Scholar] [CrossRef] [PubMed]
  103. Chetambath, R.; Kumar, P.; Nandini, V.; Chandran, S.; Chacko, A. Catamenial haemothorax—A rare cause of pleural effusion. Lung India 2023, 40, 541–544. [Google Scholar] [CrossRef] [PubMed]
  104. Zippl, A.L.; Yang Mohsin, W.S.; Gasser, E.; Henninger, B.; Widschwendter, A.; Kafka, R.; Seeber, B. Phrenic nerve paralysis after bipolar electrocoagulation of endometriosis of the diaphragm: Case report and mini review. F&S Rep. 2022, 3, 157–162. [Google Scholar] [CrossRef]
  105. Ribeiro, M.; Freire, T.; Leite, F.; Werebe, E.; Cabrera Carranco, R.; Kondo William, W. The importance of early diagnosis and treatment of incidental tension pneumothorax during robotic assisted laparoscopy for diaphragmatic endometriosis: A report of two cases. Facts Views Vis. Obgyn 2021, 13, 95–98. [Google Scholar] [CrossRef]
  106. Ciriaco, P.; Negri, G.; Libretti, L.; Carretta, A.; Melloni, G.; Casiraghi, M.; Bandiera, A.; Zannini, P. Surgical treatment of catamenial pneumothorax: A single centre experience. Interact. Cardiovasc. Thorac. Surg. 2009, 8, 349–352. [Google Scholar] [CrossRef]
  107. Ottolina, J.; De Stefano, F.; Viganò, P.; Ciriaco, P.; Zannini, P.; Candiani, M. Thoracic endometriosis syndrome: Association with pelvic endometriosis and fertility status. J. Minim. Invasive Gynecol. 2017, 24, 461–465. [Google Scholar] [CrossRef]
  108. Kawaguchi, Y.; Fujita, T.; Hanaoka, J. Catamenial pneumothorax with bullae. Ann. Thorac. Surg. 2015, 99, 1075–1078. [Google Scholar] [CrossRef]
  109. Singh, M.; Singh, R.B.; Singh, A.B.; Carballo, A.L.; Jain, A. Thoracic endometriosis: Still a diagnostic dilemma. Cureus 2021, 13, e15610. [Google Scholar] [CrossRef]
  110. Rangunwala, J.; Sitta, J.; Vyas, K.; Roda, M. Multimodality thoracoabdominal imaging findings in a rare case of thoracic endometriosis syndrome. Cureus 2020, 12, e6819. [Google Scholar] [CrossRef]
  111. Di Palo, S.; Mari, G.; Castoldi, R.; Staudacher, C.; Taccagni, G.; Di Carlo, V. Endometriosis of the lung. Respir. Med. 1989, 83, 255–258. [Google Scholar] [CrossRef] [PubMed]
  112. Kim, Y.D.; Min, K.O.; Moon, S.W. Thoracoscopic treatment of recurrent pneumothorax in a pregnant woman: A case of ectopic deciduosis. Thorac. Cardiovasc. Surg. 2020, 58, 429–430. [Google Scholar] [CrossRef] [PubMed]
  113. Rousset-Jablonski, C.; Alifano, M.; Plu-Bureau, G.; Camilleri-Broet, S.; Rousset, P.; Regnard, J.F.; Regnard, J.F.; Gompel, A. Catamenial pneumothorax and endometriosis-related pneumothorax: Clinical features and risk factors. Hum. Reprod. 2011, 26, 2322–2329. [Google Scholar] [CrossRef] [PubMed]
  114. Marques, V.D.; de Mattos, L.A.; Pimenta, A.M.; Pelloso, S.M.; Bandeira, C.O.P.; Lemos, M.M.; Moraes, W.A.S.; Carvalho, M.D.B. Resection of pulmonary endometriosis by video-assisted thoracoscopic surgery using bronchoscopy as a preoperative strategy. Ann. Thorac. Surg. 2020, 110, e391–e393. [Google Scholar] [CrossRef]
  115. Kiyan, E.; Kilicaslan, Z.; Caglar, E.; Yilmazbayhan, D.; Tabak, L.; Gürgan, M. An unusual radiographic finding in pulmonary parenchymal endometriosis. Acta. Radiol. 2002, 43, 164–166. [Google Scholar] [CrossRef]
  116. Nezhat, C.; King, L.P.; Paka, C.; Odegaard, J.; Beygui, R. Bilateral thoracic endometriosis affecting the lung and diaphragm. J. Soc. Laparosc. Robot. Surg. 2012, 16, 140–142. [Google Scholar] [CrossRef]
  117. Yu, J.H.; Lin, X.Y.; Wang, L.; Liu, Y.; Fan, C.F.; Zhang, Y.; Wang, E.H. Endobronchial endometriosis presenting as central-type lung cancer: A case report. Diagn. Pathol. 2013, 8, 53. [Google Scholar] [CrossRef]
  118. Alifano, M.; Roth, T.; Broët, S.C.; Schussler, O.; Magdeleinat, P.; Regnard, J.F. Catamenial pneumothorax: A prospective study. Chest 2003, 124, 1004–1008. [Google Scholar] [CrossRef]
  119. Ravindran, P.; Raj, R.J.; Parameswaran, K. Concurrent catamenial hemothorax and hemopneumothorax. Chest 1993, 103, 646–648. [Google Scholar] [CrossRef]
  120. Black, H.; Sigal, D.; Barnes, D.; Felisky, C.; Follette, D.; Harper, R. A 25-year-old patient with spontaneous hemothorax. Chest 2005, 128, 3080–3083. [Google Scholar] [CrossRef]
  121. Kyejo, W.; Ismail, A.; Rubagumya, D.; Bakari, R.; Kaguta, M.; Matillya, N. Shortness of breath in a young lady, rare case report of thoracic endometriosis. Int. J. Surg. Case Rep. 2022, 95, 107226. [Google Scholar] [CrossRef] [PubMed]
  122. Keijzer, S.; Oosterhuis, W.; Hazelbag, H.M.; Meuleman, T. Pathological diagnosis of thoracic endometriosis. BMJ Case Rep. 2021, 14, e243258. [Google Scholar] [CrossRef] [PubMed]
  123. Kalbi, D.P.; Al Sbihi, A.F.; Manasrah, N.; Chaudhary, A.J.; Iqbal, S. A thoracic endometriosis-related catamenial hemopneumothorax in a woman with premature ovarian failure. Cureus 2021, 13, e17110. [Google Scholar] [CrossRef] [PubMed]
  124. Mittal, A.; Jomaa, D.; Hassan, Z.; Hines, J.; Thavarajah, K. Catamenial pneumothorax in the setting of a recent stroke. Cureus 2022, 14, e23860. [Google Scholar] [CrossRef]
  125. Chittemsetti, S.; Baikunje, N.; Hosmane, G.B.; Bhat, S. Recurrent pleural effusion secondary to endometriosis: A rare malady. BMJ Case Rep. 2021, 14, e240057. [Google Scholar] [CrossRef]
  126. Patrucco Reyes, S.; Amoah, K.; Rahi, M.S.; Gunasekaran, K. A case of hemothorax as manifestation of thoracic endometrial syndrome. J. Investig. Med. High Impact Case Rep. 2021, 9, 23247096211052191. [Google Scholar] [CrossRef]
  127. Viswanath, V.; Khurana, A.; Goyal, A.; Niwariya, Y.; Singh, M.P.; Panwar, H.; Goel, G. Thoracic endometriosis presenting with bilateral hydropneumothorax. Sultan Qaboos Univ. Med. J. 2018, 18, e245–e246. [Google Scholar] [CrossRef]
  128. Bahall, V.; De Barry, L.; Singh, K. Thoracic endometriosis masquerading as Meigs’ syndrome in a young woman: A case report and literature review. Case Rep. Womens Health 2022, 36, e00452. [Google Scholar] [CrossRef]
  129. Ozvaran, M.K.; Baran, R.; Soğukpmar, O.; Uzman, O.; Sahin, K.; Kocadelioglu, I.; Aksoy, F.; Altun, S. Histopathological diagnosis of endobronchial endometriosis treated with argon laser. Respirology 2006, 11, 348–350. [Google Scholar] [CrossRef]
  130. Kuo, P.H.; Wang, H.C.; Liaw, Y.S.; Kuo, S.H. Bronchoscopic and angiographic findings in tracheobronchial endometriosis. Thorax 1996, 51, 1060–1061. [Google Scholar] [CrossRef]
  131. Cutz, J.C.; Woods, J.S.; Mitchell, J.H.; Colby, T.V.; Leslie, K.O. A common presentation with a rare cause. Eur. Respir. J. 2007, 30, 594–597. [Google Scholar] [CrossRef] [PubMed]
  132. Cassina, P.C.; Weder, W.; Hauser, M.; Kacl, G.; Imthurn, B.; Schröder, S. Catamenial hemoptysis. Chest 1997, 111, 1447–1450. [Google Scholar] [CrossRef] [PubMed]
  133. 1Sanada, T.; Park, J.; Hagiwara, M.; Ikeda, N.; Nagai, T.; Matsubayashi, J.; Saito, K. CT and MRI findings of bronchopulmonary endometriosis: A case presentation. Acta. Radiol. Open 2018, 7, 2058460118801164. [Google Scholar] [CrossRef]
  134. Derman, A.Y.; Sperling, D.; Merav, A.; Jain, V.R.; Levin, M.; Jana, S.; Haramati, L.B. Endometrioma presenting as a cavitary lung mass with intense 18F-FDG uptake on PET-CT. J. Thorac. Imaging 2007, 22, 172–175. [Google Scholar] [CrossRef] [PubMed]
  135. Mulette, P.; Jacquet, A.; Durlach, A.; Papathanassiou, D.; Lalire, P.; Graesslin, O.; Delepine, G.; Dury, S.; Dormoy, V.; Perotin, J.M.; et al. Pulmonary cavitations with increased 18F-FDG uptake revealing a thoracic endometriosis. Medicine 2021, 100, e27550. [Google Scholar] [CrossRef] [PubMed]
  136. Bateman, E.D.; Morrison, S.C. Catamenial haemoptysis from endobronchial endometriosis—A case report and review of previously reported cases. Respir. Med. 1990, 84, 157–161. [Google Scholar] [CrossRef]
  137. Orriols, R.; Muñoz, X.; Álvarez, A.; Sampol, G. Chest CT scanning: Utility in lung endometriosis. Respir. Med. 1998, 92, 876–877. [Google Scholar] [CrossRef]
  138. Inoue, T.; Kurokawa, Y.; Kaiwa, Y.; Abo, M.; Takayama, T.; Ansai, M.; Satomi, S. Video-assisted thoracoscopic surgery for catamenial hemoptysis. Chest 2001, 120, 655–658. [Google Scholar] [CrossRef]
  139. Weber, F. Catamenial hemoptysis. Ann. Thorac. Surg. 2001, 72, 1750–1751. [Google Scholar] [CrossRef]
  140. Jitruckthai, P. A woman with recurrent hemoptysis, a rare etiology. J. Med. Assoc. Thai. 2015, 98, 616–620. [Google Scholar]
  141. Kristiansen, K.; Fjeld, N.B. Pulmonary endometriosis causing haemoptysis: Report of a case treated with lobectomy. Scand. J. Thorac. Cardiovasc. Surg. 1993, 27, 113–115. [Google Scholar] [CrossRef] [PubMed]
  142. Hope-Gill, B.; Prathibha, B.V. Catamenial haemoptysis and clomiphene citrate therapy. Thorax 2003, 58, 89–90. [Google Scholar] [CrossRef] [PubMed]
  143. Park, Y.B.; Heo, G.M.; Moon, H.K.; Cho, S.J.; Shin, Y.C.; Eom, K.S.; Kim, C.H.; Lee, J.Y.; Mo, E.K.; Jung, K.S. Pulmonary endometriosis resected by video-assisted thoracoscopic surgery. Respirology 2006, 11, 221–223. [Google Scholar] [CrossRef] [PubMed]
  144. Lawrence, H.C. Pulmonary endometriosis in pregnancy. Am. J. Obstet. Gynecol. 1988, 159, 733–734. [Google Scholar] [CrossRef] [PubMed]
  145. Shiota, Y.; Umemura, S.; Arikita, H.; Horita, N.; Hiyama, J.; Tetsuya Ono, T.; Sasaki, N.; Taniyama, K.; Yamakido, M. A case of parenchymal pulmonary endometriosis, diagnosed by cytologic examination of bronchial washing. Respiration 2001, 68, 439. [Google Scholar] [CrossRef]
  146. Hachiya, T.; Okada, M.; Takamizawa, A.; Hasegawa, M.; Honda, T.; Kubo, K. Catamenial hemoptysis. Intern. Med. 2003, 42, 765–766. [Google Scholar] [CrossRef]
  147. Ryu, J.S.; Song, E.S.; Lee, K.H.; Cho, J.H.; Kwak, S.M.; Lee, H.L. Natural history and therapeutic implications of patients with catamenial hemoptysis. Respir. Med. 2007, 101, 1032–1036. [Google Scholar] [CrossRef]
  148. Terada, Y.; Chen, F.; Shoji, T.; Itoh, H.; Wada, H.; Hitomi, S. A case of endobronchial endometriosis treated by subsegmentectomy. Chest 1999, 115, 1475–1478. [Google Scholar] [CrossRef]
  149. Assor, D. Endometriosis of the lung: Report of a case. Am. J. Clin. Pathol. 1972, 57, 311–315. [Google Scholar] [CrossRef]
  150. Fujimoto, K.; Kasai, H.; Suga, M.; Sugiura, T.; Terada, J.; Suzuki, H.; Oota, M.; Yoshino, I.; Nakatani, Y.; Tatsumi, K. Pulmonary endometriosis which probably occurred through hematogenous metastasis after artificial abortion. Intern. Med. 2017, 56, 1405–1408. [Google Scholar] [CrossRef]
  151. Katoh, O.; Yamada, H.; Aoki, Y.; Matsumoto, S.; Kudo, S. Utility of angiograms in patients with catamenial hemoptysis. Chest 1990, 98, 1296–1297. [Google Scholar] [CrossRef] [PubMed]
  152. Puma, F.; Carloni, A.; Casucci, G.; Puligheddu, C.; Urbani, M.; Porcaro, G. Successful endoscopic Nd-YAG laser treatment of endobronchial endometriosis. Chest 2003, 124, 1168–1170. [Google Scholar] [CrossRef] [PubMed]
  153. Jang, H.I.; Kim, S.E.; Kim, T.J.; Lee, Y.Y.; Choi, C.H.; Lee, J.W.; Kim, B.G.; Bae, D.S. Catamenial hemoptysis accompanied by subcutaneous endometriosis treated with combination therapy. Obstet. Gynecol. Sci. 2017, 60, 236–239. [Google Scholar] [CrossRef] [PubMed]
  154. Matsushima, K.; Ono, M.; Hayashi, S.; Sonoda, D.; Matsui, Y.; Shiomi, K.; Satoh, Y.; Ohbu, M. Resection of intra-pulmonary endometriosis by video-assisted thoracoscopic surgery under pre-operative CT-guided marking synchronized with menstrual cycle. Gen. Thorac. Cardiovasc. Surg. 2020, 68, 549–553. [Google Scholar] [CrossRef]
  155. Lindenberg, K.; Schmid, J.; Rüttner, J.; Sulser, H.; Schmid, M. Endometriosis of the lung: Case report. Arch. Gynakol. 1975, 218, 219–226. [Google Scholar] [CrossRef]
  156. Zanetti, G.; Hochhegger, B.; Marchiori, E. Pulmonary endometriosis: An unusual cause of hemoptysis. J. Bras. Pneumol. 2020, 46, e20190335. [Google Scholar] [CrossRef]
  157. Tong, S.S.; Yin, X.Y.; Hu, S.S.; Cui, Y.; Li, H.T. Case report of pulmonary endometriosis and review of the literature. J. Int. Med. Res. 2019, 47, 1766–1770. [Google Scholar] [CrossRef]
  158. Bala, A.; Salim, R.A.; Deliwala, S.; Obeid, M.; Bachuwa, G. Cyclical hemoptysis and pelvic pain in a young female: A sign of thoracic endometriosis syndrome. Cureus 2020, 12, e11078. [Google Scholar] [CrossRef]
  159. Yisa, S.B.; Okenwa, A.A.; Husemeyer, R.P. Treatment of endometriotic catamenial haemoptysis with etonogestrel subdermal implant. BJOG 2004, 111, 385–386. [Google Scholar] [CrossRef]
  160. Yao, J.; Zheng, H.; Nie, H.; Li, C.F.; Zhang, W.; Wang, J.J. Endometriosis of the lung: A case report and review of literature. World J. Clin. Cases 2023, 11, 4326–4333. [Google Scholar] [CrossRef]
  161. Verhulst, E.; Bafort, C.; Tomassetti, C.; Wolthuis, A.; Bielen, D.; Coolen, J.; Weynand, B.; Platteeuw, L.; Meuleman, C.; Van Raemdonck, D. Endometriotic lung cyst causing catamenial hemoptysis; A case report and review of literature. Acta. Chir. Belg. 2022, 122, 432–437. [Google Scholar] [CrossRef] [PubMed]
  162. Son, J.H.; Kim, D.H.; Park, J.M.; Lee, S.K. Successful treatment of catamenial hemoptysis by single-incision thoracoscopic left S9+10 segmentectomy using indocyanine green injection-assisted targeting. Gen. Thorac. Cardiovasc. Surg. 2021, 69, 568–571. [Google Scholar] [CrossRef] [PubMed]
  163. Chen, C.L.; Huang, W.C.; Cheng, W.C. Catamenial hemoptysis. QJM Int. J. Med. 2020, 113, 357–358. [Google Scholar] [CrossRef] [PubMed]
  164. Chen, C.; Zhai, K.; Tang, Y.; Qu, W.; Zuo, J.; Ke, X.; Song, Y. Thoracic endometriosis: A case report and review of the literature. Ann. Palliat. Med. 2021, 10, 3500–3503. [Google Scholar] [CrossRef]
  165. Chen, M.L.; Li, C.Y. Thoracic endometriosis. N. Engl. J. Med. 2021, 385, e65. [Google Scholar] [CrossRef]
  166. Aboujaoude, N.; Iskandar, M.; Tannouri, F. Catamenial hemoptysis: A case report of pulmonary endometriosis. Eur. J. Radiol. Open 2021, 8, 100302. [Google Scholar] [CrossRef]
  167. Ganesan, P.R.; Kang, D.; Khan, Z.; Milteer, H.B. Diaphragmatic endometriosis presenting as recurrent catamenial pneumothorax: A case report. Cureus 2023, 15, e45179. [Google Scholar] [CrossRef]
  168. Bozkanat, K.M.; West, N.E.; Ladores, S.; Montemayor, K.; Tupayachi Ortiz, M.G.; Christianson, M.; Jain, R. Catamenial haemoptysis in females with cystic fibrosis: A case series with review of management strategies. Respirol. Case Rep. 2021, 9, e00755. [Google Scholar] [CrossRef]
  169. Chao, Y.K.; Ko, P.J.; Yeow, K.M.; Liu, Y.H. Video-assisted thoracoscopic surgery for catamenial hemoptysis: The rationale of preoperative computed tomography-guided hook-wire localization. Surg. Laparosc. Endosc. Percutaneous Tech. 2006, 16, 437–438. [Google Scholar] [CrossRef]
  170. Fleishman, S.; Davidson, J.F. Vicarious menstruation, a likely case of pulmonary endometriosis. Lancet 1959, 274, 88–99. [Google Scholar] [CrossRef]
  171. Rodman, M.H.; Jones, C.W. Catamenial hemoptysis due to bronchial endometriosis. N. Engl. J. Med. 1962, 266, 805–808. [Google Scholar] [CrossRef] [PubMed]
  172. Hertzanu, Y.; Heimer, D.; Hirsch, M. Computed tomography of pulmonary endometriosis. Comput. Radiol. 1987, 11, 81–84. [Google Scholar] [CrossRef] [PubMed]
  173. Lu, M.S.; Liu, Y.H.; Wu, Y.C.; Hsieh, M.J.; Liu, H.P. What we see is not what we get in catamenial haemoptysis: Catamenial haemoptysis. Int. J. Clin. Pract. 2006, 60, 232–233. [Google Scholar] [CrossRef] [PubMed]
  174. Haruki, T.; Fujioka, S.; Adachi, Y.; Miwa, K.; Taniguchi, Y.; Nakamura, H. Successful video-assisted thoracic surgery for pulmonary endometriosis: Report of a case. Surg. Today 2007, 37, 141–144. [Google Scholar] [CrossRef] [PubMed]
  175. Lee, C.H.; Huang, Y.C.; Huang, S.F.; Wu, Y.K.; Kuo, K.T. Thoracic endometriosis: Rare presentation as a solitary pulmonary nodule with eccentric cavitations. Thorax 2009, 64, 919–920. [Google Scholar] [CrossRef]
  176. Nakashima, Y.; Shoji, F.; Osoegawa, A.; Yoshino, I.; Maehara, Y. Catamenial hemoptysis treated by video-assisted thoracic surgery: Report of a case. Surg. Today 2011, 41, 701–703. [Google Scholar] [CrossRef]
  177. Chatra, P.S. Thoracic endometriosis: A case report. J. Radiol. Case Rep. 2012, 6, 25–30. [Google Scholar] [CrossRef]
  178. Okur, A.; Metin, B.; İntepe, Y.S.; Serin, H.İ. Catamenial hemoptysis: A case report. Tuberk. Toraks. 2014, 62, 151–153. [Google Scholar] [CrossRef]
  179. Furuya, K.; Otsuka, H.; Koezuka, S.; Makino, T.; Hata, Y.; Wakayama, M.; Shibuya, K.; Iyoda, A. Resection of pulmonary endometriosis using video-assisted thoracoscopic surgery under preoperative CT-guided marking. Gen. Thorac. Cardiovasc. Surg. 2017, 65, 175–178. [Google Scholar] [CrossRef]
  180. Alwadhi, S.; Kohli, S.; Chaudhary, B.; Gehlot, K. Thoracic endometriosis—A rare cause of haemoptysis. J. Clin. Diagn. Res. 2016, 10, TD01–TD02. [Google Scholar] [CrossRef]
  181. Koizumi, T.; Inagaki, H.; Takabayashi, Y.; Kubo, K. Successful use of gonadotropin-releasing hormone agonist in a patient with pulmonary endometriosis. Respiration 1999, 66, 544–546. [Google Scholar] [CrossRef] [PubMed]
  182. Takahashi, M.; Matsukura, T.; Hirai, T.; Mino, N. Recurrent catamenial hemopneumothorax treated by coverage with polyglycolic acid sheets. J. Thorac. Cardiovasc. Surg. 2013, 145, 300–302. [Google Scholar] [CrossRef] [PubMed]
  183. Nezhat, C.; Nicoll, L.M.; Bhagan, L.; Huang, J.Q.; Bosev, D.; Hajhosseini, B.; Beygui, R.E. Endometriosis of the diaphragm: Four cases treated with a combination of laparoscopy and thoracoscopy. J. Minim. Invasive Gynecol. 2009, 16, 573–580. [Google Scholar] [CrossRef] [PubMed]
  184. Huber, M.; Wierrani, F.; Böhm, G.; Hauck, H.; Lintner, F.; Grünberger, W. Multiple endometrial stromal nodules with sparse cysts and glands in the lung—A nodular variation of endometriosis that may mimic metastases of sarcoma. Pathol. Res. Pract. 1999, 195, 59–64. [Google Scholar] [CrossRef] [PubMed]
  185. Ludwig, M.; Bauer, O.; Wiedemann, G.J.; Diedrich, K. Ureteric and pulmonary endometriosis. Arch. Gynecol. Obstet. 2001, 265, 158–161. [Google Scholar] [CrossRef]
  186. Brown, A.; Deshmukh, M.; Tavare, A.; Gillmore, R. Endometriosis: A rare cause of multiple lung nodules on imaging. Br. J. Hosp. Med. 2018, 79, 110–111. [Google Scholar] [CrossRef]
  187. Choi, S.Y.; Kim, C.K.; Park, C.B. Successful treatment of catamenial hemoptysis by video-assisted thoracoscopic surgery. Thorac. Cardiovasc. Surg. 2013, 61, 94–96. [Google Scholar] [CrossRef]
  188. Kim, C.J.; Nam, H.S.; Lee, C.Y.; Yum, H.K.; Yang, S.H.; Seo, K.H.; Son, C.H.; Kim, D.J.; Jang, S.H.; Chung, M.P.; et al. Catamenial hemoptysis: A nationwide analysis in Korea. Respiration 2010, 79, 296–301. [Google Scholar] [CrossRef]
  189. Legras, A.; Mansuet-Lupo, A.; Rousset-Jablonski, C.; Bobbio, A.; Magdeleinat, P.; Roche, N.; Regnard, J.F.; Gompel, A.; Damotte, D.; Alifano, M. Pneumothorax in women of child-bearing age: An update classification based on clinical and pathologic findings. Chest 2014, 145, 354–360. [Google Scholar] [CrossRef]
  190. Attaran, S.; Bille, A.; Karenovics, W.; Lang-Lazdunski, L. Videothoracoscopic repair of diaphragm and pleurectomy/abrasion in patients with catamenial pneumothorax: A 9-year experience. Chest 2013, 143, 1066–1069. [Google Scholar] [CrossRef]
  191. Saito, T.; Saito, Y.; Fukumoto, K.J.; Matsui, H.; Nakano, T.; Taniguchi, Y.; Kaneda, H.; Konobu, T.; Tsuta, K.; Murakawa, T. Clinical and pathological characteristics of spontaneous pneumothorax in women: A 25-year single-institutional experience. Gen. Thorac. Cardiovasc. Surg. 2018, 66, 516–522. [Google Scholar] [CrossRef] [PubMed]
  192. Hwang, S.M.; Lee, C.W.; Lee, B.S.; Park, J.H. Clinical features of thoracic endometriosis: A single center analysis. Obstet. Gynecol. Sci. 2015, 58, 223–231. [Google Scholar] [CrossRef] [PubMed]
  193. Cameron, H.M.; Path, M.C.; Park, W.W.; Path, M.C. Decidual tissue within the lung. BJOG 1965, 72, 748–754. [Google Scholar] [CrossRef] [PubMed]
  194. Wang, H.C.; Kuo, P.H.; Kuo, S.H.; Luh, K.T. Catamenial hemoptysis from tracheobronchial endometriosis: Reappraisal of diagnostic value of bronchoscopy and bronchial brush cytology. Chest 2000, 118, 1205–1208. [Google Scholar] [CrossRef] [PubMed]
  195. Chung, S.Y.; Kim, S.J.; Kim, T.H.; Ryu, W.G.; Park, S.J.; Lee, D.Y.; Paik, H.C.; Kim, H.J.; Cho, S.H.; Kim, J.K.; et al. Computed tomography findings of pathologically confirmed pulmonary parenchymal endometriosis. J. Comput. Assist. Tomogr. 2005, 29, 815–818. [Google Scholar] [CrossRef]
  196. Kim, C.H.; Lee, D.Y.; Moon, D.H.; Lee, S. Percutaneous cryoablation of multiple pulmonary endometriosis. J. Chest Surg. 2021, 54, 75–78. [Google Scholar] [CrossRef]
  197. Huang, H.; Li, C.; Zarogoulidis, P.; Darwiche, K.; Machairiotis, N.; Yang, L.; Simoff, M.; Celis, E.; Zhao, T.; Zarogoulidis, K.; et al. Endometriosis of the lung: Report of a case and literature review. Eur. J. Med. Res. 2013, 18, 13. [Google Scholar] [CrossRef]
  198. Hong, Y.J.; Paik, H.C.; Kim, H.J.; Lee, D.Y.; Kim, S.J.; Cho, S.H.; Oh, Y.M. A case of parenchymal pulmonary endometriosis. Yonsei Med. J. 1999, 40, 514–517. [Google Scholar] [CrossRef]
  199. Kumakiri, J.; Kumakiri, Y.; Miyamoto, H.; Kikuchi, I.; Arakawa, A.; Kitade, M.; Takeda, S. Gynecologic evaluation of catamenial pneumothorax associated with endometriosis. J. Minim. Invasive Gynecol. 2010, 17, 593–599. [Google Scholar] [CrossRef]
  200. Muramatsu, T.; Shimamura, M.; Furuichi, M.; Nishii, T.; Ishimoto, S.; Morooka, H.; Yagasaki, C.; Ohmori, K.; Shiono, M. Surgical treatment of catamenial pneumothorax. Asian J. Surg. 2010, 33, 199–202. [Google Scholar] [CrossRef]
  201. Lopes, S.; Maciel, J.; Cabral Bastos, P.; Pinho, P. What about having a hydropneumothorax every month? Rev. Port. Cir. Cardiotorac. Vasc. 2017, 24, 145. [Google Scholar] [PubMed]
  202. Rometti, M.; Patti, L. Catamenial pneumothorax in a patient with endometriosis: A case report. Cureus 2023, 15, e42193. [Google Scholar] [CrossRef] [PubMed]
  203. Guidry, G.G.; George, R.B.; Payne, D.K. Catamenial hemoptysis: A case report and review of the literature. J. La State Med. Soc. 1990, 142, 27–30. [Google Scholar] [PubMed]
  204. Joseph, J.; Reed, C.E.; Sahn, S.A. Thoracic endometriosis. Recurrence following hysterectomy with bilateral salpingo-oophorectomy and successful treatment with talc pleurodesis. Chest 1994, 106, 1894–1896. [Google Scholar] [CrossRef]
  205. Kirschner, P.A. Porous diaphragm syndromes. Chest Surg. Clin. N. Am. 1998, 8, 449–472. [Google Scholar]
  206. Yeh, T.J. Endometriosis within the thorax: Metaplasia, implantation, or metastasis? J. Thorac. Cardiovasc. Surg. 1967, 53, 201–205. [Google Scholar] [CrossRef]
  207. Olive, D.L.; Pritts, E.A. Treatment of endometriosis. N. Engl. J. Med. 2001, 345, 266–275. [Google Scholar] [CrossRef]
  208. Alifano, M.; Trisolini, R.; Cancellieri, A.; Regnard, J.F. Thoracic endometriosis: Current knowledge. Ann. Thorac. Surg. 2006, 81, 761–769. [Google Scholar] [CrossRef]
  209. Schwartz, K.; Llarena, N.C.; Rehmer, J.M.; Richards, E.G.; Falcone, T. The role of pharmacotherapy in the treatment of endometriosis across the lifespan. Expert Opin. Pharmacother. 2020, 21, 893–903. [Google Scholar] [CrossRef]
Jpm 14 01085 g001
Figure 1. PRISMA flow diagram for the present study.
Figure 1. PRISMA flow diagram for the present study.
Jpm 14 01085 g001
Table 1. Symptoms of pulmonary endometriosis mentioned in the studies included in the systematic review.
Table 1. Symptoms of pulmonary endometriosis mentioned in the studies included in the systematic review.
SymptomNumber of Cases (592)References
Pneumothorax405[4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71]
Chest pain130[3,5,6,8,9,10,11,12,13,14,15,16,17,18,19,20,21,23,25,26,27,28,29,32,35,36,38,40,42,43,44,45,46,50,51,52,53,54,55,56,58,59,62,64,66,68,69,70,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108]
Dyspnea124[6,7,8,9,10,11,13,14,15,17,21,23,25,27,36,39,42,43,44,47,51,52,56,59,60,63,64,66,68,69,70,72,76,79,80,82,86,87,91,93,95,96,97,98,99,100,103,106,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128]
Catamenial hemoptysis84[3,4,10,13,19,35,37,58,73,81,82,83,84,85,88,89,90,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181]
Cough40[9,13,16,39,44,47,52,61,63,73,82,86,87,92,99,100,106,108,109,117,119,120,125,127,134,156,181]
Hemothorax22[44,77,82,106,126,182,183]
Pelvic–abdominal pain14[5,6,41,48,75,85,105,128,177,183,184,185]
Hydropneumothorax12[39,46,47,63,76,82,88,100,119,122,127]
Flu-like4[58,65,133,186]
Shock state1[58]
Asymptomatic2[13,182]
Table 2. Smoking habits of the patients included in the systematic review.
Table 2. Smoking habits of the patients included in the systematic review.
Smoking HabitsNumber of Cases (592)References
Smokers47[67,69,70,102,107,111,137,147,164,171,186,187,188,189,190]
Ex-smokers8[107,133,135,147,188,191]
Non-smokers78[8,9,12,21,22,25,27,28,39,40,41,42,46,50,60,61,71,81,84,85,87,92,93,100,101,107,112,114,117,120,121,131,136,140,152,153,161,166,167,174,176,178,180,183,188,192]
Not mentioned460[4,5,6,7,10,11,13,14,15,17,18,19,20,23,24,26,29,30,31,32,33,34,35,36,37,38,43,44,45,47,48,49,51,52,53,54,55,56,57,58,59,62,63,64,65,66,68,72,73,74,75,76,78,79,80,82,83,86,88,89,90,91,94,95,96,97,98,99,103,104,105,106,108,109,110,115,116,118,119,122,123,124,125,126,127,128,129,130,132,134,138,139,141,142,143,144,145,146,148,149,150,151,154,155,156,157,158,159,160,162,163,165,168,169,170,172,173,175,177,179,181,182,184,185,190,193,194,195,196,197,198,199,200,201,202,203]
Table 3. Location of endometrial lesions in each lung of patients included in the systematic review.
Table 3. Location of endometrial lesions in each lung of patients included in the systematic review.
LocationNumber of Cases (592)References
Right lung473[4,5,6,7,8,9,10,11,12,13,15,16,17,18,19,20,21,22,24,25,26,27,28,29,30,31,32,33,34,35,37,38,39,40,41,43,44,45,47,48,49,50,51,52,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,114,116,118,120,121,122,123,124,125,126,127,128,129,130,131,132,137,138,139,140,141,143,146,147,148,149,150,153,154,158,159,160,161,164,165,166,167,169,172,174,175,176,177,179,181,182,185,188,189,190,191,192,193,194,195,196,198,199,200,201,202]
Left lung47[4,12,13,14,23,57,72,88,90,111,116,117,133,134,136,142,144,145,151,152,162,168,170,171,173,178,180,187,189,190,191,192,194,197,200,204]
Bilateral29[13,36,42,46,47,57,71,82,88,90,107,109,115,116,119,135,155,156,157,184,186,189,193,196]
Table 4. Location of endometrial lesions in each lobe of patients included in the systematic review.
Table 4. Location of endometrial lesions in each lobe of patients included in the systematic review.
LocationNumber of Cases (138)References
Right upper lobe45[10,13,16,17,42,63,65,81,85,108,128,131,132,137,138,139,143,147,153,154,158,159,163,164,165,166,169,177,188,192,196,201]
Right middle lobe13[130,147,149,157,160,165,174,176,179,188,192,195]
Right lower lobe36[13,16,18,19,61,64,83,89,114,115,130,131,140,141,146,147,148,149,150,156,157,165,172,175,181,184,185,188,192,195,196,198]
Left upper lobe–Lingula28[13,14,23,117,131,136,142,151,152,157,168,170,171,173,192,196,197]
Light lower lobe16[13,72,115,133,134,144,145,152,156,162,173,178,180,184,187]
Table 5. Extra-thoracic endometriosis diagnosed in patients included in the systematic review.
Table 5. Extra-thoracic endometriosis diagnosed in patients included in the systematic review.
Extra-thoracic EndometriosisNumber of Cases
(592)		References
Yes222[5,6,7,12,13,18,21,25,28,30,31,32,33,34,35,37,40,41,42,45,46,47,48,55,56,57,59,61,62,63,64,65,66,69,70,71,72,73,74,75,77,78,79,80,82,85,86,88,90,93,95,97,98,99,100,101,102,104,105,106,107,109,110,114,115,116,118,121,122,123,126,128,134,135,158,159,166,167,183,185,189,190,192,199,200,202,204]
No242[3,4,9,13,20,22,23,31,32,35,38,39,43,54,57,58,59,66,76,81,82,83,86,106,107,111,117,118,125,129,130,132,136,138,140,141,142,143,144,145,147,152,155,161,170,174,176,177,180,181,183,184,186,187,189,190,192,194,196,198,199]
Not mentioned127[8,10,11,14,15,17,19,24,26,27,29,30,36,44,49,50,51,52,53,60,67,68,84,87,89,91,92,94,96,103,108,112,119,120,124,127,131,133,137,139,146,148,149,150,151,153,154,156,157,160,162,163,164,165,168,169,171,172,173,175,178,179,182,188,191,193,195,197,200,201,203]
Table 6. Previous gynecological procedures of patients included in the systematic review.
Table 6. Previous gynecological procedures of patients included in the systematic review.
Previous Gynecological ProceduresNumber of Cases (592)References
Yes212[13,15,18,21,28,29,32,35,42,45,46,48,55,58,59,61,63,64,66,70,72,73,78,82,83,86,90,93,95,98,105,107,114,115,116,119,122,123,131,133,134,135,136,138,142,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,161,164,166,169,170,171,172,173,175,179,180,181,183,184,188,190,191,192,194,195,197,198,199,200,203,204]
No184[3,9,24,32,35,39,40,52,59,82,86,87,89,90,104,107,109,125,126,128,132,137,162,167,182,183,187,188,190,191,192,194,195,199,200]
Not mentioned197[4,5,6,7,8,10,11,12,13,14,17,19,20,22,23,25,26,27,30,31,33,34,36,37,38,41,43,44,47,49,50,51,53,54,56,57,60,62,65,66,67,68,69,71,74,75,76,77,79,80,81,84,85,88,91,92,94,96,97,99,100,101,102,103,106,108,109,110,111,112,117,118,120,121,124,127,129,130,139,140,141,143,160,163,165,168,174,176,177,178,183,185,186,189,193,196,201,202]
Table 7. Type of main previous gynecological procedures of patients included in the systematic review.
Table 7. Type of main previous gynecological procedures of patients included in the systematic review.
Previous Gynecological ProcedureNumber of Cases (211)References
Abortions28[15,55,64,115,133,138,142,144,145,146,150,151,154,155,164,165,169,171,172,173,179,180,181,184,194,195,197,198,203]
Dilatations and Curettages44[13,15,55,64,73,82,83,115,131,133,136,138,142,144,145,146,147,150,151,154,155,156,161,164,169,170,171,172,173,179,180,181,184,195,197,198]
Cesarian sections19[13,29,66,73,107,135,136,144,152,153,161,170,175,191,194,197]
Hysterectomy with/without oophorectomy18[3,13,20,37,41,45,46,77,96,116,117,135,136,148,149,192,200,204]
Diagnostic Laparotomy11[28,58,72,82,90,93,95,119,166,200,204]
Cystectomy9[35,42,48,59,66,123,148]
Myomectomy5[61,134,199]
Diagnostic Laparoscopy50[21,28,32,55,63,66,78,86,90,98,105,107,114,122,142,157,158,159,161,183,190,192,199]
Table 8. Chest X-ray findings of patients with pulmonary endometriosis included in the systematic review.
Table 8. Chest X-ray findings of patients with pulmonary endometriosis included in the systematic review.
Chest X-Ray FindingsNumber of Cases (189)References
Pneumothorax72[5,6,7,8,10,13,14,15,17,18,20,21,22,23,25,26,27,28,29,32,33,36,37,38,39,40,43,46,47,48,50,51,52,54,55,56,59,60,61,62,63,64,65,66,68,69,70,72,92,118]
Nodules17[13,33,37,44,61,75,89,119,133,134,155,175,184,185,186]
Consolidation23[13,37,63,75,89,109,115,123,130,133,134,143,145,148,151,155,170,175,185,197]
Pleural effusion26[3,7,42,47,64,87,91,92,94,95,96,97,98,99,102,103,109,110,119,120,124,125,126,127,128,202]
Hydropneumothorax10[46,47,76,88,100,110,119,122,124,127]
Hemothorax1[77]
Atelectasis2[70,109]
No pathological findings38[73,83,84,85,93,132,135,136,137,138,139,140,141,144,146,147,151,153,154,159,161,162,165,172,173,174,176,180,181,192,194]
Table 9. Chest computed tomography findings of patients with pulmonary endometriosis included in the systematic review.
Table 9. Chest computed tomography findings of patients with pulmonary endometriosis included in the systematic review.
Chest CT 1 FindingsNumber of Cases (195)References
Cystic lesions
(Bullae–Cavities)		30[12,14,15,18,19,23,37,71,101,108,109,114,127,134,135,137,146,151,154,156,158,159,161,163,165,175,179,187,192,196]
Pneumothorax20[5,8,9,11,16,17,18,19,21,28,33,37,41,43,48,65,69,70,72,106]
Ground-glass opacities42[19,85,89,109,135,140,142,143,147,150,152,153,154,156,158,162,163,164,165,166,174,175,176,177,178,179,192,195]
Ring-shaped lesions1[115]
Nodules35[6,18,19,32,33,35,37,46,67,84,89,101,106,111,117,132,133,137,146,151,154,156,158,159,166,175,179,184,185,186,188,192,195]
Peribronchial infiltrates4[130,148,152,194]
Consolidation21[4,13,37,81,93,109,115,130,138,144,145,151,157,160,172,173,181,188,195,197,198]
Pleural effusion22[7,45,64,80,87,91,93,97,98,99,103,109,110,120,123,126,127,128,167,182,202,203]
Hydropneumothorax7[39,64,88,100,122,125,127]
Hemothorax2[17,77]
No pathological findings11[21,50,63,73,74,76,135,139,162,170,194]
1 CT: Computed tomography.
Table 10. Bronchoscopical findings of patients with pulmonary endometriosis included in the systematic review.
Table 10. Bronchoscopical findings of patients with pulmonary endometriosis included in the systematic review.
Bronchoscopical FindingsNumber of Cases (66)References
Macroscopic (endometrial) lesions11[4,111,117,129,130,134,136,137,152,194,198]
Hemorrhage–Hyperemia27[10,19,83,84,89,114,129,131,138,139,140,141,142,143,144,145,150,151,156,163,164,165,172,174,177,180,187,195,197]
No pathological findings28[12,19,71,77,79,80,85,131,132,142,144,146,147,159,168,170,171,172,173,193,194,195,203,205]
Table 11. Histopathological findings of patients with pulmonary endometriosis included in the systematic review.
Table 11. Histopathological findings of patients with pulmonary endometriosis included in the systematic review.
Histopathological FindingsNumber of Cases (295)References
Endometrial cells or glands144[7,8,9,10,13,14,17,18,20,21,22,25,29,32,33,35,42,43,44,45,46,47,50,51,52,56,57,59,62,64,65,66,68,70,72,73,74,77,78,79,80,81,83,84,86,88,89,91,95,97,98,99,100,101,102,103,104,106,112,113,115,119,123,125,126,127,130,131,133,134,135,137,138,143,144,145,147,148,150,151,153,155,156,157,160,162,164,165,167,168,170,171,172,175,176,177,181,182,184,187,191,192,193,194,196,197,198,199,200,201,205,206,207]
Endometrial cells through washing or lavage6[130,140,145,152,177,194]
Glands, stroma, and hemosiderin-laden macrophages61[13,16,19,48,111,114,116,128,133,134,148,149,150,153,154,155,157,160,163,165,169,171,173,174,175,178,189,192,193,195,197,198,199]
ER 1, PR 2, CD-10 384[17,21,29,33,34,52,83,86,102,112,113,123,127,131,145,148,163,165,170,172,185,189,196,198,200,206,207,208]
1 ER: Estrogen receptor; 2 PR: progesterone receptor; 3 CD: cluster of differentiation.
Table 12. Therapeutic approach of patients with pulmonary endometriosis included in the systematic review.
Table 12. Therapeutic approach of patients with pulmonary endometriosis included in the systematic review.
Therapeutic ApproachNumber of Cases (592)References
Surgical treatment276
Thoracotomy95[9,11,27,29,33,35,43,45,50,51,53,62,69,70,72,73,74,77,83,88,92,93,96,98,99,101,119,121,133,134,135,137,140,145,147,153,156,157,159,160,161,162,165,166,168,170,172,173,176,177,179,180,181,184,189,192,197,198,200,208]
Pleurectomy38[17,20,31,43,48,51,60,93,100,101,117,153,159,164,166,190,197]
Hysterectomy with/without oophorectomy10[20,46,77,90,95,109,128]
Laparoscopy39[35,73,74,78,90,104,105,126,183,185,202]
Laparotomy7[20,41,77,102,109,121,128]
Minimally invasive techniques231
Bronchial artery embolization5[89,168,189]
Endobronchial laser3[111,129,152]
Cryoablation1[196]
VATS 1219[9,11,12,14,16,18,21,22,23,25,27,28,30,31,32,33,34,36,37,38,40,43,45,48,49,50,51,53,55,57,61,64,65,66,67,70,72,76,77,90,91,96,99,101,105,106,107,108,109,110,114,116,118,122,123,124,125,127,131,132,133,138,143,153,154,156,161,163,165,167,173,174,175,176,178,179,182,184,187,188,189,190,191,192,195,200,201]
RATS 23[7,63,79]
Hormonal treatment63
Androgens41[15,47,62,81,82,83,111,118,119,127,130,136,144,148,151,170,172,180,194]
Progestins41[4,5,11,14,16,17,23,24,25,26,28,32,58,73,75,78,92,93,97,104,112,119,124,125,126,127,128,153,159,164,169,174,185,192]
GnRH 3 analogues98[6,9,11,20,21,22,25,26,29,30,31,46,49,51,52,53,56,58,59,63,65,69,71,74,78,92,93,95,96,99,100,101,102,105,107,109,117,119,124,128,136,137,138,142,148,150,151,153,154,158,160,161,163,165,168,170,173,184,190,192,195,197,198,207]
Combined oral contraceptives44[8,16,39,75,106,107,108,136,147,150,158,168,177,188,199]
Surgical + Hormonal treatment220[4,5,6,8,9,11,14,15,16,17,18,20,21,22,23,24,25,26,28,29,30,31,32,35,44,46,47,49,51,52,53,56,58,59,61,63,65,69,70,71,73,74,75,76,77,78,91,92,93,95,96,97,98,99,100,101,102,104,105,106,107,109,112,113,117,118,119,120,124,125,126,127,128,130,132,134,135,136,137,138,142,148,150,151,153,154,157,158,159,160,161,162,164,165,167,168,169,173,174,182,184,185,190,192,194,195,197,198,199,205,206,207,208]
None14[87,88,137,144,145,146,147,186,188]
Not mentioned8[116,134,168,193]
1 VATS: Video-assisted thoracoscopy; 2 RATS: Robotic-assisted thoracoscopy; 3 GnRH: Gonadotropin-releasing hormones.
Table 13. Recurrency after different therapeutic approaches in patients with pulmonary endometriosis included in the systematic review.
Table 13. Recurrency after different therapeutic approaches in patients with pulmonary endometriosis included in the systematic review.
Therapeutic ApproachNumber of CasesReferences
Surgical treatment4
Minimally invasive techniques
Bronchial artery embolization3[168]
Endobronchial laser1[111]
Hormonal treatment16[4,8,9,81,82,141,142,143,148,151,188,192]
Surgical + Hormonal treatment40[11,23,30,31,32,38,40,49,55,57,63,67,69,73,82,86,106,111,167,182,192,199,200]
Not mentioned43[6,13,19,21,24,28,36,41,48,51,53,59,66,74,87,88,92,94,100,105,107,115,116,124,126,131,134,146,147,149,158,162,168,173,178,186,193,196,202]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Nikolettos, K.; Patsouras, A.; Kotanidou, S.; Garmpis, N.; Psilopatis, I.; Garmpi, A.; Effraimidou, E.I.; Daniilidis, A.; Dimitroulis, D.; Nikolettos, N.; et al. Pulmonary Endometriosis: A Systematic Review. J. Pers. Med. 2024, 14, 1085. https://doi.org/10.3390/jpm14111085

AMA Style

Nikolettos K, Patsouras A, Kotanidou S, Garmpis N, Psilopatis I, Garmpi A, Effraimidou EI, Daniilidis A, Dimitroulis D, Nikolettos N, et al. Pulmonary Endometriosis: A Systematic Review. Journal of Personalized Medicine. 2024; 14(11):1085. https://doi.org/10.3390/jpm14111085

Chicago/Turabian Style

Nikolettos, Konstantinos, Alexandros Patsouras, Sonia Kotanidou, Nikolaos Garmpis, Iason Psilopatis, Anna Garmpi, Eleni I. Effraimidou, Angelos Daniilidis, Dimitrios Dimitroulis, Nikos Nikolettos, and et al. 2024. "Pulmonary Endometriosis: A Systematic Review" Journal of Personalized Medicine 14, no. 11: 1085. https://doi.org/10.3390/jpm14111085

APA Style

Nikolettos, K., Patsouras, A., Kotanidou, S., Garmpis, N., Psilopatis, I., Garmpi, A., Effraimidou, E. I., Daniilidis, A., Dimitroulis, D., Nikolettos, N., Tsikouras, P., Gerede, A., Papoutsas, D., Kontomanolis, E., & Damaskos, C. (2024). Pulmonary Endometriosis: A Systematic Review. Journal of Personalized Medicine, 14(11), 1085. https://doi.org/10.3390/jpm14111085

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop