A Case of Catamenial Hemoptysis Treated by Bronchial Artery Embolization

Shin, Suk Pyo; Park, Chi Young; Song, Ji Hyun; Kim, Hong Min; Min, Daniel; Lee, Sang-Hwan; Kang, San Ha; Jeon, Gyeong Sik; Lee, Ji‐Hyun

doi:10.4046/trd.2014.76.5.233

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…The primary goal of surgery for thoracic endometriosis is to minimize recurrence by precisely locating the lesions and completely removing them, when all other conservative measures fail. In our study, the single patient that underwent bronchial artery embolization experienced no recurrence; this is consistent with a report from another institution [ 19 ], suggesting embolization may be suitable as a first line treatment. Because of the risks of thoracic surgery, operative management should be a last resort in cases where symptoms prevail.…”

Section: Discussionsupporting

confidence: 92%

Clinical features of thoracic endometriosis: A single center analysis

Hwang

Lee

et al. 2015

Obstet Gynecol Sci

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ObjectiveTo analyze the diagnostic profiles and treatment outcomes of patients with thoracic endometriosis at a university hospital.MethodsA retrospective review of medical records was performed for patients diagnosed with thoracic endometriosis at Gangnam Severance Hospital, Yonsei University College of Medicine, between January 2007 and January 2014.ResultsFifteen patients (median age, 35 years; range, 23-48 years) were evaluated. Patients presented with catamenial hemoptysis (n=8), or catamenial pneumothorax (n=7). Patients with catamenial pneumothorax were significantly older than those presenting with hemoptysis (P=0.0002). Only 3 patients (20%) had coexisting pelvic endometriosis. All patients underwent chest computed tomography; lesions were shown to predominantly affect the right lung (right lung, n=13, 86.7%; left lung, n=2, 13.3%), and were mainly distributed on the right upper lobe (n=9, 60%). Ten patients underwent video-assisted thoracoscopic surgery, and 1 patient underwent a thoracotomy. Intraoperatively, endometriosis-specific findings were observed in 8/11 patients (72.7%); a further 5/11 patients (45.4%) had histologically detectable endometriosis. Over the follow-up period (mean, 18.4 months; range, 2-65 months) 5/15 patients (33%) had clinical signs of recurrence. Recurrence was not detected in any of the 5 catamenial pneumothorax patients that received adjuvant hormonal therapy after surgery.ConclusionThe diagnosis and management of thoracic endometriosis requires a multidisciplinary approach, based upon skillful differential diagnosis, and involving careful gynecologic evaluation and assessment of the cyclicity of pulmonary symptoms. Imaging findings are non-specific, though there may be laterality towards the right lung. Since symptom recurrence is more common in those with presenting with pneumothorax, post-operative adjuvant medical therapy is recommended.

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Section: Discussionsupporting

confidence: 92%

Clinical features of thoracic endometriosis: A single center analysis

Hwang

Lee

et al. 2015

Obstet Gynecol Sci

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“…Massive hemoptysis can be caused by a variety of conditions, such as infections (mycobacterial, fungal, or bacterial), medications, cocaine, bronchitis, bronchiectasis, tumors eroding into the pulmonary vasculature, endobronchial tumors, vascular abnormalities, endometrial tissue (catamenial hemorrhage), foreign bodies, and fistulas between major arteries and the bronchial tree. [1][2][3][4][5][6][7] Its incidence is difficult to assess, as there is no unifying definition of the condition. Bronchiectasis is a common cause, accounting for 31% to 66% of cases.…”

Section: Discussionmentioning

confidence: 99%

Massive hemoptysis managed by rescue extracorporeal membrane oxygenation

Endicott-Yazdani

Wood

Trinh³

et al. 2018

Baylor University Medical Center Proceedings

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Massive hemoptysis can have a rapid and potentially fatal clinical course. A 68-year-old woman presented with recurrent hemoptysis complicated by refractory hypoxemia and shock despite aggressive intervention. The use of veno-venous extracorporeal membrane oxygenation was a nontraditional intervention that ultimately proved to be lifesaving, but is by no means recommended for routine use in this setting.

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“…Fatal hemoptysis from CH has not yet been reported but it may cause life-threatening asphyxiation. Recent studies have reported massive hemoptysis requiring bronchial embolization in CH [9,10]. In addition, recurrent hemoptysis by CH can reduce the quality of life of patients due to the associated respiratory symptoms and anxiety.…”

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confidence: 99%

Recurrent hemoptysis in a 26-year-old woman with a ground-glass opacity lesion of the lung

Kim

Park

2020

Yeungnam Univ J Med

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Hemoptysis is a major reason for emergency department (ED) visits. Catamenial hemoptysis (CH), a rare condition of thoracic endometriosis, can cause recurrent hemoptysis but is difficult to diagnose in the ED due to the scarcity of cases and nonspecific clinical findings. We report a case of a 26-year-old woman who presented to the ED with recurrent hemoptysis since 2 years without a definite cause. Her vital signs and blood test findings were unremarkable. Chest computed tomography (CT) did not show any specific lesions other than a non-specific ground-glass opacity pattern in her right lung. She was on day 4 of her menstrual cycle and her hemoptysis frequently occurred during menstruation. Although there was no histological confirmation, based on her history of hemoptysis during menstruation and no other cause of the hemoptysis, the patient was tentatively diagnosed with CH and was administered gonadotropin-releasing hormone. She had no recurrence of hemoptysis for 3 months. While CH is difficult to diagnose in the ED, the patient's recurrent hemoptysis related to menstruation was a clue to the presence of CH. Therefore, physicians should determine the relationship between hemoptysis and menstruation for women of childbearing age presenting with repeated hemoptysis without a definite cause.

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A Case of Catamenial Hemoptysis Treated by Bronchial Artery Embolization

Cited by 3 publications

References 14 publications

Clinical features of thoracic endometriosis: A single center analysis

Clinical features of thoracic endometriosis: A single center analysis

Massive hemoptysis managed by rescue extracorporeal membrane oxygenation

Recurrent hemoptysis in a 26-year-old woman with a ground-glass opacity lesion of the lung

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