A case of pulmonary endometriosis treated by video-assisted thoracoscopic surgery

Abstract

A 24-year-old woman experienced sudden hemosputum and hemoptysis during her menstruation period in October 2002. Her past history was dilatation and curettage at 23-years-old. She showed repeated catamenial hemosputum during every menstruation period. Chest CT revealed infiltrative shadows in the left S³, right S⁸, and right S⁶ areas. Bronchoscopic examination revealed hemorrhage from a left B³a bronchus but a transbronchial lung biopsy was not able to confirm ectopic endometrial tissue. After follow-up over the proceeding three months due to the persistence of hemosputum, video-assisted thoracoscopic surgery (VATS) was performed. A lesion was identified as the hemorrhage site under the visceral pleura via the thoracoscope, and diagnosed as pulmonary endometriosis pathologically. VATS may be considered as one of the useful procedures for the diagnosis and treatment of pulmonary endometriosis. It is important that the lesion causing hemoptysis or hemosputum is identified by chest CT and bronchoscopy during the menstruation period for reliable determination of the region which should be resected.