- 期刊
Thoracic Endometriosis-A Case Report and Literature Review
胸腔子宮內膜異位症－病例報告及文獻回顧
摘要
咳血是肺部疾病非特異性的徵象。但若其發生於停經前婦女且與經期相關，則需考慮胸腔子宮內膜異位症之可能性。胸腔子宮內膜異位症是一種罕見疾病。依據子宮內膜異位的位置可區分為肺實質及肋膜子宮內膜異位。臨床及影像上主要的表現，包括：月經性氣胸、月經性血胸、月經性咳血及肺結節。治療的方法仍未有定論，在所有文獻報告中，目前仍然是以手術治療，以及術後合併使用荷爾蒙治療以抑制排卵及子宮內膜的活性最為有效。在此，我們報告一位49歲的女性病人以月經性咳血和呼吸困難為最初表現，影像上呈現右側氣胸併肋膜積水，同時血中CA-125上升。經一系列檢查及手術肋膜切片，證實為胸腔子宮內膜異位症。在本文中同時回顧胸腔子宮內膜異位症的臨床表現、病理機轉及治療策略，並探討CA-125在胸腔子宮內膜異位症的相關角色。
並列摘要
Hemoptysis can be caused by a variety of pulmonary diseases, including infection, cardiovascular disorders, systemic disorders, trauma and malignancy. If it recurs and correlates with the time of menstruation in a pre-menopausal woman, a diagnosis of thoracic endometriosis should be highly suspected. We report the case of 49-year-old woman who presented with recurrent episodes of hemoptysis and dyspnea, coincident with the time of menstruation, for 1 year. Chest X-ray and computed tomography (CT) yielded significant right-sided hydropneu-mothorax. Thoracentesis revealed bloody pleural effusion. An elevated tumor marker cancer antigen-125 (CA-125) level was noted. Chest echo-guided pleural biopsy and thoracotomy led to a diagnosis of endometriosis. The patient underwent decortication of the right involved pleura and received danazol (Ladogal®) treatment after surgery. No recurrence of hemoptysis was noted during 6 months of follow-up. In this report, we also review the various presentations, pathogeneses and therapies of thoracic endometriosis, and discuss the role of CA-125 in thoracic endometriosis.