Journal of medical case reports · 2026
Thoracoabdominal endometriosis mimicking pulmonary tuberculosis in a TB-endemic setting: a case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Lamuwalla Murtaza, Ali Rukhsaar, Ngimbwa Joshua, Ngimba Caroline, Arafa Mahmoud, Mathew Blessing, Makakala Mandela
Аннотация
BACKGROUND: Endometriosis is a common gynecologic condition, but extra-pelvic manifestations are rare and often pose significant diagnostic challenges. Thoracic and abdominal endometriosis may present with nonspecific respiratory and abdominal symptoms that closely mimic pulmonary tuberculosis, particularly in TB-endemic regions, leading to delayed or incorrect diagnosis.
CASE PRESENTATION: We report the case of a 40-year-old Tanzanian woman with a previous history of treated pulmonary tuberculosis who presented with a 6-month history of progressive shortness of breath, right-sided chest pain, and abdominal distension. Imaging revealed a massive right hydropneumothorax with near-total lung collapse and ascites, initially raising concern for post-tuberculous disease. Pleural fluid cytology demonstrated a hemorrhagic effusion. Diagnostic laparoscopy revealed hemorrhagic ascites, mesenteric nodular lesions, and extensive uterine adhesions. Histopathological examination of the mesenteric nodules confirmed endometriosis. The patient was treated with gonadotropin-releasing hormone agonist therapy (goserelin) and underwent pleurodesis, with subsequent clinical improvement and resolution of symptoms.
CONCLUSION: This case highlights thoracoabdominal endometriosis as an important differential diagnosis in women of reproductive age presenting with unexplained respiratory symptoms in TB-endemic settings. Awareness of this rare entity is essential to avoid misdiagnosis and unnecessary anti-tuberculous therapy. Early consideration of extra-pelvic endometriosis and timely histological confirmation can facilitate appropriate management and improve patient outcomes.
CASE PRESENTATION: We report the case of a 40-year-old Tanzanian woman with a previous history of treated pulmonary tuberculosis who presented with a 6-month history of progressive shortness of breath, right-sided chest pain, and abdominal distension. Imaging revealed a massive right hydropneumothorax with near-total lung collapse and ascites, initially raising concern for post-tuberculous disease. Pleural fluid cytology demonstrated a hemorrhagic effusion. Diagnostic laparoscopy revealed hemorrhagic ascites, mesenteric nodular lesions, and extensive uterine adhesions. Histopathological examination of the mesenteric nodules confirmed endometriosis. The patient was treated with gonadotropin-releasing hormone agonist therapy (goserelin) and underwent pleurodesis, with subsequent clinical improvement and resolution of symptoms.
CONCLUSION: This case highlights thoracoabdominal endometriosis as an important differential diagnosis in women of reproductive age presenting with unexplained respiratory symptoms in TB-endemic settings. Awareness of this rare entity is essential to avoid misdiagnosis and unnecessary anti-tuberculous therapy. Early consideration of extra-pelvic endometriosis and timely histological confirmation can facilitate appropriate management and improve patient outcomes.