Thoracic Endometriosis: a Clinical Review and Update of Current and Evolving Diagnostic and Therapeutic Techniques

Ravi Kanth Velagapudi, John P. Egan
In: Current Pulmonology Reports · 2021 · vol. 10(1) , pp. 22–29 · doi:10.1007/s13665-021-00269-z · W3126598215
review OA: hybrid CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review discusses the pathophysiology, diagnosis, and management of thoracic endometriosis, highlighting the utility of video-assisted thoracoscopic surgery and medical thoracoscopy for diagnosis and treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This clinical review examines thoracic endometriosis (TE), focusing on proposed pathophysiology, its varied presentation (especially catamenial pneumothorax, catamenial hemothorax/hemorrhagic pleural effusion, and catamenial hemoptysis), and the diagnostic and therapeutic approaches used in practice. The paper synthesizes evidence on how TE is evaluated with high clinical suspicion, imaging such as chest X-ray/CT and sometimes chest MRI timed to menses, and direct visualization of endometrial lesions via video-assisted thoracoscopic surgery (VATS) or medical thoracoscopy, noting that there is no specific laboratory test (including CA-125, which is discussed as having higher specificity but poor sensitivity). Major caveats include reliance on case-based and observational evidence inherent to TE’s rarity and heterogeneity, and the lack of standardized diagnostic certainty beyond endoscopic visualization. This paper is centrally about endometriosis — it is a review of thoracic endometriosis diagnosis and management and its relationship to catamenial chest presentations.

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Abstract

Abstract Purpose of Review The goal of this review is to provide a comprehensive understanding of the pathophysiology, clinical presentation, diagnostic workup, and clinical management of thoracic endometriosis (TE), as well as highlight our personal experience with TE workup and management. Recent Findings TE can present in a wide range of clinical manifestations. Without high clinical suspicion, diagnosis can be delayed. Since no specific laboratory testing is available, diagnosis is often based on careful history taking, imaging, and direct visualization of endometrial lesions through video-assisted thoracoscopic surgery (VATS). Medical thoracoscopy (MT) may also be a useful tool in the diagnostic workup of TE. Summary The diagnosis and management of TE require a multidisciplinary approach and a high index of clinical suspicion. While VATS remains the gold standard for diagnosis, we share our experience using MT to diagnose and manage a case of TE-related hemothorax.

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endometriosisthoracic_endometriosis

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last seen: 2026-06-10T17:14:06.276822+00:00
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