Thoracic Endometriosis: Still a Diagnostic Dilemma

Madhu Singh, Rahul B Singh, Abhishek B Singh, Abhishek Singh, Aziel L Carballo, Ayushi Jain
Cureus · 2021 · vol. 13(6) , pp. e15610 · doi:10.7759/cureus.15610 · PMID:34131552 · PMC8196491 · W3171785828
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a patient with thoracic endometriosis syndrome presenting with shortness of breath and cough, diagnosed by concurrent pelvic endometriosis found during laparotomy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This Cureus case report studies thoracic endometriosis syndrome (TES) by describing a 38-year-old woman with a five-week history of progressive shortness of breath, cough, and wheezing, whose imaging showed a large right-sided bloody pleural effusion with atelectasis/consolidation and also bulky fibroid uterus with ascites and elevated CA-125. The authors highlight that TES was considered due to the hemorrhagic pleural effusion and clinical context, and a clinical diagnosis was confirmed by pelvic endometriosis evidence at laparotomy, followed by depot medroxyprogesterone and surgery (total hysterectomy with bilateral salpingo-oophorectomy). A key limitation is that pleural fluid cytology was inadequate to rule out malignancy and histopathology/special stains or immunohistochemistry were unavailable, so the diagnosis remained clinical rather than tissue-confirmed in the pleural space. This paper is centrally about endometriosis — it presents a thoracic endometriosis syndrome case with diagnostic challenges involving hemorrhagic pleural effusion.

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Abstract

We report a case of thoracic endometriosis syndrome (TES) presenting with a five-week history of progressive shortness of breath, cough, and wheezing. Investigations revealed a large, right-sided pleural effusion that was bloody on aspiration. A diagnosis of TES was one of the diagnoses entertained and eventually confirmed on finding evidence of pelvic endometriosis on laparotomy. The management of TES should include hormonal therapy, surgical management, or a combination of both.

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endometriosisthoracic_endometriosis

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