Video-Assisted Thoracic Surgery for Pulmonary Endometriosis -Report of 1 Case-

흉강경을 이용한 폐 자궁내막증의 절제 -1예 보고-

  • Cho, Seong Joon (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kangwon National University) ;
  • Rhyu, Se Min (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kangwon National University) ;
  • Kim, Woo Jin (Department of Internal Medicine, College of Medicine, Kangwon National University) ;
  • Lee, Seung-Joon (Department of Internal Medicine, College of Medicine, Kangwon National University) ;
  • Kim, Yeon Soo (Department of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, College of Medicine, Inje University)
  • 조성준 (강원대학교 의과대학 흉부외과학교실) ;
  • 류세민 (강원대학교 의과대학 흉부외과학교실) ;
  • 김우진 (강원대학교 의과대학 내과학교실) ;
  • 이승준 (강원대학교 의과대학 내과학교실) ;
  • 김연수 (인제대학교 일산백병원 흉부외과학교실)
  • Received : 2005.09.13
  • Accepted : 2006.05.17
  • Published : 2006.05.30

Abstract

Pulmonary endometriosis is an uncommon disease, and usually detected by catamenial hemoptysis. Treatment of pulmonary endometriosis may be medical(hormone therapy) or surgical. Since hormone therapy may cause sterility, most of patients who wish to conceive usually choose surgical resection. Although video-assisted thoracic surgery(VATS) has advantage of small scar, reducing postoperative pain and shortening hospital stay, it is not easy to locate the precise lesion and resect whole endometrial tissue not to be remained. 17 years old female with catamenial hemoptysis was treated sucessfully with a partial resection of the lung using VATS, and has been asymptomatic for 7months since the operation.

폐 자궁내막증은 월경 시 주기적인 각혈을 동반하는 매우 드문 질환이다. 치료법으로는 호르몬요법인 내과적 방법과 외과적으로 절제하는 방법이 있다. 호르몬 요법은 가임기의 젊은 여성에게 불임을 유발한다는 제약점이 있으므로 대부분의 환자에서 수술 치료를 선택하게 된다. 흉강경을 이용한 절제는 젊은 여성에게 흉터를 최소화하고 통증과 회복기간을 줄일 수 있지만 정확히 병변의 위치를 찾아 자궁내막조직이 남아 재발하지 않도록 완전히 병변을 제거하기가 쉽지 않다. 본 증례에서는 월경 시 각혈을 동반한 17세 된 미혼여성에게 발견된 폐 자궁내막증을 흉강경을 이용하여 절제하였으며, 수술 후 8개월의 기간 동안 재발없이 관찰 중이다.

Keywords

References

  1. Parks WW. Experimental trophoblastic embolism of the lungs. J Pathol Bacteriol 1958;75:257-65 https://doi.org/10.1002/path.1700750204
  2. Vinatier D, Orazi G, Cosson M, Dufour P. Theories of endometriosis. Eur J Obstet Gynecol Reprod Biol 2001;96:21-34 https://doi.org/10.1016/S0301-2115(00)00405-X
  3. Kwak YT, Maeng DH, Bae CY, Lee SH, Kim JS, Lee HP. Catamenial hemoptysis: report of one case. Korean J Thorac Cardiovasc Surg 2000;33:597-600
  4. Jang WC, Yu U, Kim BP, Choi YS, Hong SB, Oh BS. A case of pulmonary endometriosis causing catamenial hemoptysis. Korean J Thorac Cardiovasc Surg 2004;37:95-7
  5. Kim KJ, Cho YH, Choi BK, Choi EU, Chang YS, Kim HJ, et al. Pulmonary endometriosis. Tuberc Respir Dis 1999;47:389-93 https://doi.org/10.4046/trd.1999.47.3.389
  6. Lee SM, Chung SC, Kim SD, Ma KA, Kim YJ, Song YG, et al. Catamenial hemoptysis caused by the endometriosis of the lung parenchyme, treated with Bisegmental Wedge Resection. Tuberc Respir Dis 1997;44:197-202 https://doi.org/10.4046/trd.1997.44.1.197
  7. Ham HS, Chung MP, Lee BW, Han KH, Kim HJ, Han JH, et al. A case of pulmonary endometriosis resected by video-assisted thoracoscopic surgery. Tuberc Respir Dis 2004;56:542-9 https://doi.org/10.4046/trd.2004.56.5.542
  8. Choi JH, Kim MJ, Park WB, Ha JH, Lee JH. A case of parenchymal pulmonay endometriosis. Korean J Obstet Gynecol 1995;38:1318-22
  9. Kiyan E, Kilicaslan Z, Caglar E, Yilmazbayhan D, Tabak L, Gurgan M. An unusual radiographic finding in pulmonary parenchymal endometriosis. Acta Radiol 2002;43:164-6
  10. Inoue T, Kurokawa Y, Kaiwa Y, Abo M, Takayama T, Ansai M, et al. Video-assisted thoracoscopic surgery for catamenial hemoptysis. Chest 2001;120:655-8 https://doi.org/10.1378/chest.120.2.655
  11. Alifano M, Roth T, Broet SC, Schussler O, Magdeleinat P, Regnard JF. Catamenial pneumothorax: a prospective study. Chest 2003;124:1004-8 https://doi.org/10.1378/chest.124.3.1004