Thoracic Endometriosis Detected During Medical Thoracoscopy in a Tertiary Care Setting - A Retrospective Observational Study

Abstract

Background: Thoracic endometriosis is a very rare clinical situation mostly presenting with pleural diseases, that is often misdiagnosed or missed due to the lack of specific clinical features. This report aims to explore the clinical characteristics, thoracoscopic findings, histopathology, treatment, and prognosis of women with thoracic endometriosis, providing a reference for the diagnosis and management of thoracic endometriosis.

Design/Methods: Clinical data of 3 patients diagnosed with pleural endometriosis from among 50 consecutive thoracoscopic procedures conducted in a tertiary care hospital in North Kerala were analysed from electronic hospital records. The clinical features, thoracoscopic findings, histopathological features, treatment process, and prognosis were summarized.

Results: Among the 3 female patients with pleural endometriosis, there were 2 cases of catamenial pneumothorax and one case of catamenial haemothorax. The age ranged from 43 years to 44 years. All the 3 cases were diagnosed by thoracoscopic pleural biopsy.

Conclusions: Thoracic endometriosis syndrome is extremely rare, and clinical diagnosis is always missed or delayed due to nonspecific symptoms. Diagnosis mainly relies on pathological findings and immunohistochemical detection. Most cases were managed conservatively with hormonal therapy or by inducing surgical menopause.