Thoracic endometriosis – multidisciplinary approach to diagnosis and treatment (Literature review)

Worldwide, the prevalence of endometriosis among women of reproductive age is approximately 10%. This pathology is often accompanied by damage to the pelvic organs, primarily the reproductive system, and is manifested by pain syndrome (dysmenorrhea, dyschezia, chronic pelvic pain, dyspareunia, dysuria), abnormal uterine bleeding, infertility. However, the spread of endometriosis lesions also occurs outside the pelvic cavity and abdominal cavity (lesions in the intestines, peritoneum, bladder, ureters). Extragenital foci can be found in the tissue of the diaphragm, lungs, pleura, skin.Thoracic endometriosis is manifested by damage to the pleura and lungs. Given that thoracic endometriosis is a pathology that is not common, there is not a sufficient number of publications in the scientific literature that would cover the data of hundreds of patients with thoracic endometriosis. The vast majority of reports are the descriptions of clinical cases. This article presents clinical cases of various forms of thoracic endometriosis in patients of different ages. Often this disease is accompanied by such clinical symptoms as cough, hemoptysis, shortness of breath, chest pain. Such manifestations can last for several months and often coincide with the onset of menstruation. Patients are primarily diagnosed with pneumothorax, hemothorax. Often the diagnosis of thoracic endometriosis is not fast and takes a period from several days to months. Visual diagnostic methods – chest radiography, computed tomography, magnetic resonance imaging, bronchoscopy, video-assisted thoracoscopy – are among the main diagnostic methods. Taking a tissue biopsy with a histological conclusion is crucial for confirming the diagnosis of thoracic endometriosis. Often this extragenital form of endometriosis is combined with endometriosis of the uterus, ovaries, fallopian tubes and peritoneum.Treatment of endometriosis includes surgical intervention with appropriate surgical correction and removal of endometrial foci. To prevent recurrence of pathology, patients often receive a consultation of gynecologist with recommendations to use hormonal therapy – combined oral contraceptives, gonadotropin-releasing hormone agonists, progestogens.Only a multidisciplinary approach involving doctors from different specialties (family doctor, surgeon, radiologist, gynecologist) is the most effective for the diagnosis and treatment of thoracic endometriosis with the lowest frequency of recurrences in the future.