PLEURAL ENDOMETRIOSIS: BLOODY PLEURAL EFFUSION IN A 28-YEAR-OLD FEMALE WITH PRIMARY INFERTILITY (CASE REPORT)

S Saheer, Akhil Paul, Prince James, R. Palak
In: International Journal of Medicine and Medical Research · 2021 · vol. 6(2) , pp. 11–15 · doi:10.11603/ijmmr.2413-6077.2020.2.11512 · W3176951483
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes pleural endometriosis presenting as non-resolving hemorrhagic pleural effusion in a 28-year-old infertile female, diagnosed via medical thoracoscopy and histology.

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This paper is a case report describing pleural endometriosis presenting as a non-resolving hemorrhagic pleural effusion in a 28-year-old woman being treated for primary infertility, who had also received empirical anti-tubercular therapy for four months. The authors report that medical thoracoscopy identified flat brownish-grey plaques on the diaphragmatic pleura and that pleural tissue histology confirmed pleural endometriosis, with subsequent gonadotropin releasing hormone–leuprolide initiation associated with some clinico-radiological improvement; a key limitation is the single-patient design inherent to a case report. The paper explicitly states thoracic endometriosis should be considered among differentials for pleural effusion in such patients and highlights medical thoracoscopy before empirical treatments. This paper is centrally about endometriosis — it specifically documents pleural (thoracic) endometriosis causing bloody pleural effusion.

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Abstract

Background. Endometriosis is defined as presence of endometrial glands outside the uterine cavity and it most commonly involves the structures within the pelvic cavity. Thoracic endometriosis syndrome usually presents as pneumothorax, hemoptysis, hemothorax or pulmonary nodules. Endometriosis presenting as hemorrhagic pleural effusion is rarely reported. Objectives. The aim of the study was to describe pleural endometriosis presenting as hemorrhagic pleural effusion and to insist on the role of medical thoracoscopy in making the diagnosis with the help of a case report. Methods. A case report of pleural endometriosis as a non-resolving hemorrhagic pleural effusion is presented. Results. A 28-years old female on treatment for her primary infertility presented with non-resolving bloody pleural effusion and she was on empirical anti-tubercular drugs for the last four months. Medical thoracoscopy revealed flat brownish grey plaques over the diaphragmatic pleura and the histology of pleural tissue revealed pleural endometriosis. She was initiated on gonadotropin releasing hormone-leuprolide and there was some clinico-radiological improvement. Conclusions. Thoracic endometriosis should be considered as one of the differentials for pleural effusion in female patient especially on treatment for infertility. Medical thoracoscopy should be the investigation of choice for evaluating pleural effusions before initiating empirical treatments.
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PLEURAL ENDOMETRIOSIS: BLOODY PLEURAL EFFUSION IN A 28-YEAR-OLD FEMALE WITH PRIMARY INFERTILITY (CASE REPORT) DOI: https://doi.org/10.11603/ijmmr.2413-6077.2020.2.11512Keywords: pleural endometriosis, catamenial pleural effusion, thoracic endometriosis syndrome, hemorrhagic pleural effusionAbstract Background. Endometriosis is defined as presence of endometrial glands outside the uterine cavity and it most commonly involves the structures within the pelvic cavity. Thoracic endometriosis syndrome usually presents as pneumothorax, hemoptysis, hemothorax or pulmonary nodules. Endometriosis presenting as hemorrhagic pleural effusion is rarely reported. Objectives. The aim of the study was to describe pleural endometriosis presenting as hemorrhagic pleural effusion and to insist on the role of medical thoracoscopy in making the diagnosis with the help of a case report. Methods. A case report of pleural endometriosis as a non-resolving hemorrhagic pleural effusion is presented. Results. A 28-years old female on treatment for her primary infertility presented with non-resolving bloody pleural effusion and she was on empirical anti-tubercular drugs for the last four months. Medical thoracoscopy revealed flat brownish grey plaques over the diaphragmatic pleura and the histology of pleural tissue revealed pleural endometriosis. She was initiated on gonadotropin releasing hormone-leuprolide and there was some clinico-radiological improvement. Conclusions. Thoracic endometriosis should be considered as one of the differentials for pleural effusion in female patient especially on treatment for infertility. Medical thoracoscopy should be the investigation of choice for evaluating pleural effusions before initiating empirical treatments. References Alifano M, Trisolini R, Cancellieri A, Regnard JF. Thoracicendometriosis: current knowledge. Ann Thorac Surg. 2006; 81:761-9. DOI: https://doi.org/10.1016/j.athoracsur.2005. 07.044 Sevinç S, Unsal S, Oztürk T et al. Thoracic endometriosis syndrome with bloody pleural effusion in a 28 year old woman. J Pak Med Assoc. 2013 Jan; 63:114-6. Rived X, Sebastián F, Rodríguez JI et al. Endometriosispleural complicada. Neumotórax catamenial. Cir Esp. 2002; 67:114-5. Joseph J, Sahn SA. Thoracic endometriosis syndrome: new observations from an analysis of 110 cases. J Med. 1996;100:164-70. DOI: https://doi.org/10.1016/S0002-9343(97) 89454-5 Channabasavaiah AD, Joseph JV. Thoracic endometriosis: revisiting the association between clinical presentation and thoracic pathology based on thoracoscopic findings in 110 patients. Medicine (Baltimore). 2010;89:183- 8. DOI: https://doi.org/10.1097/MD.0b013e3181df67d5 Bagan P, Le Pimpec Barthes F, Assouad J et al. Catamenial pneumothorax: retrospective study of surgical treatment. Ann Thorac Surg. 2003;75:378- 81. DOI: https://doi.org/10.1016/S0003-4975(02) 04320-5 Alifano M, Jablonski C, Kadiri H et al. Catamenial and noncatamenial, endometriosis-related or nonendometriosis-related pneumothorax referred for surgery. Am J Respir Crit Care Med. 2007;176:1048- 53. Downloads Published How to Cite Issue Section License Copyright (c) 2021 International Journal of Medicine and Medical Research This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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