A Case Series of Endometrial Cast in A Medical College in Kanchipuram

Abstract

Endometrial casts are a rare clinical phenomenon characterized by the shedding of the entire endometrial lining as a single piece, often associated with significant pain and menstrual irregularities. This case series aims to describe the clinical presentation, diagnostic findings, treatment, and outcomes of patients presenting with endometrial casts.  Data collected included patient demographics, clinical presentation, imaging findings, treatment modalities, and outcomes. Results: Five patients, aged 22 to 40, presented with acute pelvic pain and passage of tissue masses during menstruation. Imaging, primarily transvaginal ultrasound and MRI, identified echogenic masses within the uterine cavity consistent with endometrial casts. Treatment varied: two patients received conservative management with analgesics, one patient was treated with hormonal therapy, and two patients underwent hysteroscopic removal of the casts. Histopathological examination confirmed endometrial casts in all cases. All patients experienced significant symptom relief post-treatment, with no recurrences reported during follow-up. Conclusion: Endometrial casts, although rare, should be considered in women presenting with severe dysmenorrhea and passage of tissue during menstruation. Accurate diagnosis using imaging and histopathological confirmation is crucial. Treatment should be individualized, ranging from conservative management to surgical intervention. Increased awareness and further research are needed to better understand and manage this condition