{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:52:52Z","timestamp":1793717572925,"version":"4.6.1"},"reference-count":209,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Endometriosis is characterized by the presence of ectopic endometrial-like glands and stroma outside the endometrial cavity, which mainly occurs in the pelvic cavity. Pulmonary endometriosis, or thoracic endometriosis syndrome (TES), describes the rare presence of endometrial-like cells in the thoracic cavity and includes catamenial pneumothorax, catamenial hemothorax, hemoptysis, and lung nodules. Our aim is to summarize the results of all reported cases of TES. Methods: Extensive research was conducted through MEDLINE\/PUBMED using the keywords \u201cthoracic endometriosis\u201d, \u201cthoracic endometriosis syndrome\u201d, \u201ccatamenial pneumothorax\u201d, \u201ccatamenial hemoptysis\u201d, and \u201cTES\u201d. Following PRISMA guidelines, all published cases of TES between January 1950 and March 2024 were included. A systematic review of 202 studies in English, including 592 patients, was performed. Results: The median age of women with TES is 33.8 years old. The most common clinical presentation is catamenial pneumothorax (68.4%), while lesions are mainly found in the right lung unilaterally (79.9%). Chest computed tomography (CT) was used alone or after an X-ray to determine the pathological findings. Ground-glass opacity nodules and cystic lesions represent the most common finding in CT, while pneumothorax is the most common finding in X-rays. Video-assisted thoracoscopic surgery (VATS) is the main therapeutic approach, usually in combination with hormonal therapy, including GnRH analogues, progestins, androgens, or combined oral contraceptives. Hormonal therapy was also administered as monotherapy. Symptom recurrence was reported in 10.1% of all cases after the treatment. Conclusions: High clinical awareness and a multidisciplinary approach are necessary for the best clinical outcome for TES patients. More studies are required to extract safer conclusions.<\/jats:p>","DOI":"10.3390\/jpm14111085","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T12:31:32Z","timestamp":1730377892000},"page":"1085","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pulmonary Endometriosis: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8291-5375","authenticated-orcid":false,"given":"Konstantinos","family":"Nikolettos","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros","family":"Patsouras","sequence":"additional","affiliation":[{"name":"Second Department of Pulmonology, Sotiria General Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0706-7918","authenticated-orcid":false,"given":"Sonia","family":"Kotanidou","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9980-0056","authenticated-orcid":false,"given":"Nikolaos","family":"Garmpis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sotiria General Hospital, 11527 Athens, Greece"},{"name":"N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8516-6242","authenticated-orcid":false,"given":"Iason","family":"Psilopatis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Erlangen Hospital, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0258-5965","authenticated-orcid":false,"given":"Anna","family":"Garmpi","sequence":"additional","affiliation":[{"name":"First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni I.","family":"Effraimidou","sequence":"additional","affiliation":[{"name":"First Surgical Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0044-9214","authenticated-orcid":false,"given":"Angelos","family":"Daniilidis","sequence":"additional","affiliation":[{"name":"First University Department in Obstetrics and Gynecology, Papageorgiou General Hospital, School of Medicine, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Dimitroulis","sequence":"additional","affiliation":[{"name":"Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikos","family":"Nikolettos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Tsikouras","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeliki","family":"Gerede","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Papoutsas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sotiria General Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Kontomanolis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68110 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5454-2564","authenticated-orcid":false,"given":"Christos","family":"Damaskos","sequence":"additional","affiliation":[{"name":"N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"},{"name":"Department of Emergency Surgery, Laiko General Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.jmig.2019.10.004","article-title":"Extrapelvic Endometriosis: A Systematic Review","volume":"27","author":"Andres","year":"2020","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"hoac009","DOI":"10.1093\/hropen\/hoac009","article-title":"ESHRE guideline: Endometriosis","volume":"2022","author":"Becker","year":"2022","journal-title":"Hum. Reprod. 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