Pleural Endometriosis: A Case Study in Mpigi District, Uganda.

Edson Willy Habimana, Ritah Bakesiima
In: sjhr · 2023 · doi:10.51168/sjhrafrica.v4i3.326 · W4322100225
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This case study describes a 29-year-old Ugandan woman presenting with monthly chest pain and shortness of breath, ultimately diagnosed with pleural endometriosis based on biopsy findings of endometrial tissue on the pleural membrane.

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This paper reports a case study of a 29-year-old woman in Mpigi District, Uganda, who presented with cyclic shortness of breath, right-sided chest pain, mild non-productive cough, and a sensation consistent with fluid movement, with symptoms recurring monthly at the start of menses. Chest X-ray showed a moderate right-sided pleural effusion, and the cause was otherwise described as idiopathic; the authors performed a pleural tissue biopsy because the timing matched menstrual periods. Biopsy demonstrated endometrial tissue implanted on the pleural membrane, leading to the diagnosis of pleural endometriosis. The paper emphasizes that pleural endometriosis has no specific risk factors or distinctive signs and can be misdiagnosed as pneumonia. This paper is centrally about endometriosis — it specifically documents pleural endometriosis diagnosed via pleural biopsy in a woman with a cyclic pleural effusion.

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Abstract

Background: It is estimated that 10% of women of reproductive age have endometriosis where the incidence is noted to be as high as 49% in women with chronic pelvic pain. The most common form of endometriosis is abdominopelvic endometriosis, but there are rare cases where there is the presence of endometrial tissue in the thoracic cavity. Pleural endometriosis is a form of thoracic endometriosis in which the endometrial tissue is found on the pleural membrane. Case presentation: A 29-year-old female came into our hospital presenting with shortness of breath, the feeling of fluids splashing into the right chest, right-sided chest pains, mild non-productive cough. The signs and symptoms were always present monthly at the start of her menses. Results: The chest X-ray findings revealed a right-sided moderate pleural effusion. The cause of this pleural effusion remained idiopathic. However, since her history of presenting complaints was aligned with menstrual periods, a pleural tissue biopsy was done, which revealed endometrial tissue implanted on the pleural membrane. Conclusion: Pleural endometriosis is a rare but existing form of endometriosis with no specific risk factors or signs and symptoms. This explains why many have misdiagnosed it calling it pneumonia. Clinicians are recommended to take a detailed history from patients regardless of how unrelated some complaints may seem. “It seemed unrelated for a pleural effusion with a cough to become a gynecological issue”.
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Background

It is estimated that 10% of women of reproductive age have endometriosis where the incidence is noted to be as high as 49% in women with chronic pelvic pain. The most common form of endometriosis is abdominopelvic endometriosis, but there are rare cases where there is the presence of endometrial tissue in the thoracic cavity. Pleural endometriosis is a form of thoracic endometriosis in which the endometrial tissue is found on the pleural membrane. Case presentation: A 29-year-old female came into our hospital presenting with shortness of breath, the feeling of fluids splashing into the right chest, right-sided chest pains, mild non-productive cough. The signs and symptoms were always present monthly at the start of her menses.

Results

The chest X-ray findings revealed a right-sided moderate pleural effusion. The cause of this pleural effusion remained idiopathic. However, since her history of presenting complaints was aligned with menstrual periods, a pleural tissue biopsy was done, which revealed endometrial tissue implanted on the pleural membrane.

Conclusion

Pleural endometriosis is a rare but existing form of endometriosis with no specific risk factors or signs and symptoms. This explains why many have misdiagnosed it calling it pneumonia. Clinicians are recommended to take a detailed history from patients regardless of how unrelated some complaints may seem. “It seemed unrelated for a pleural effusion with a cough to become a gynecological issue”. Downloads Published How to Cite Issue Section License Copyright (c) 2023 EDSON WILLY HABIMANA, Ritah Bakesiima This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Condition tags

endometriosisthoracic_endometriosischronic_pelvic_pain

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