Medical therapy has been recommended as the first choice in pulmonary endometriosis. It consists of the suppression of endometrial tissue with progesterone (ie, pseudopregnancy) or danazol (ie, pseudomenopause). Danazol is a synthetic steroid with antiestrogenic and light androgenic effects that affects ovarian hormone synthesis.11–
It has proved to be effective in curing or controlling symptoms, even in patients who are nonresponsive to ovulation suppression,12
but a variable recurrence rate after the cessation of therapy has been reported.1,13
Furthermore, heavy side effects of the hormonal therapy often are observed, including climacteric symptoms, virilization, weight gain, and sterility.4
Surgery should be the preferred method if the patient wishes to become pregnant, if the side effects of hormonal therapy are intolerable, or in case of recurrence when the drug therapy is discontinued. Pulmonary resection is indicated when a single point of bleeding has been located definitively. For peripheral lesions, thoracoscopic wedge resections have been successfully performed.4,14
In patients with centrally located bronchial endometriosis, subsegmentectomy, segmentectomy, or lobectomy are required.3,15–17
Treatment with oophorectomy has been reported in the literature,18
but it seems to be an extreme solution and should be avoided.