Duyos Inmaculada, López-Carrasco Ana, Hernández Alicia, Zapardiel Ignacio, de Santiago Javier
Gynecology Department, La Paz University Hospital, Madrid, Spain.
Gynecology Department, La Paz University Hospital, Madrid, Spain.
Eur J Obstet Gynecol Reprod Biol. 2014 Jul;178:56-9. doi: 10.1016/j.ejogrb.2014.03.026. Epub 2014 Apr 12.
Thoracic endometriosis is a relatively rare type of endometriosis and includes catamenial pneumothorax, hemothorax and hemoptysis, and presence of intrathoracic endometriotic nodules. We want to clarify and resume the most appropriate management of this pathology.
We retrospectively reviewed all the cases of thoracic endometriosis diagnosed and followed up in our Unit from 2005 to 2013. This search revealed five women, with a mean age of 34.5 (26-44). Four had previous history of endometriosis or severe dysmenorrhea. One patient complained of chronic shoulder pain with diaphragmatic implants, another one presented catamenial hemoptysis, and three women suffered from catamenial pneumothorax, with right-side preference.
Three patients underwent surgery and all of them were treated with GnRH agonists at least during 6 month referring improvement in symptoms. After 1-8 years follow-up, all these patients remain asymptomatic.
The optimal management of thoracic endometriosis needs further evaluation but the combined approach by hormonal therapy and surgery could be the best option.
胸段子宫内膜异位症是一种相对罕见的子宫内膜异位症类型，包括经期气胸、血胸和咯血，以及胸内子宫内膜异位结节的存在。我们希望阐明并恢复对这种疾病最合适的管理方法。
我们回顾性分析了2005年至2013年在我们科室诊断并随访的所有胸段子宫内膜异位症病例。此次检索发现了5名女性，平均年龄为34.5岁（26 - 44岁）。其中4人有子宫内膜异位症或严重痛经病史。1例患者因膈肌植入物出现慢性肩部疼痛，另1例出现经期咯血，3名女性患有经期气胸，以右侧居多。
3例患者接受了手术，所有患者至少接受了6个月的GnRH激动剂治疗，症状有所改善。经过1 - 8年的随访，所有这些患者均无症状。
胸段子宫内膜异位症的最佳管理方法需要进一步评估，但激素治疗和手术相结合的方法可能是最佳选择。
