PLEURAL ENDOMETRIOSIS: INTEGRATIVE ANALYSIS OF CLINICAL MANIFESTATIONS, DIAGNOSIS AND THERAPEUTIC INTERVENTIONS

Abstract

Endometriosis is a common gynecological disease characterized by the presence of endometrial tissue outside the uterine cavity. Although predominantly found in pelvic organs, it can rarely occur in the chest, resulting in pleural endometriosis. This integrative review explores the clinical manifestations, diagnostic methods and treatments of pleural endometriosis. The review included studies from the last ten years, published in English or Portuguese, focused on clinical manifestations, surgical procedures and outcomes of patients with pleural effusion due to endometriosis. The most common symptoms are chest pain, dyspnea and hemoptysis, often associated with the menstrual cycle. Diagnosis is challenging and delayed, with pleural fluid cytology, pleural biopsies and imaging studies being the main diagnostic tools. Hormonal treatments, such as GnRH analogues and oral contraceptives, are effective, but have a high relapse rate. Surgical interventions such as pleurectomy and pleurodesis via video-assisted thoracoscopic surgery (VATS) show better long-term results. Pleural endometriosis requires a multidisciplinary approach and early diagnosis for effective management. The combination of hormonal and surgical therapies is one of the best strategy to minimize recurrences and improve patients' quality of life.