Rare Endometriosis Cases Challenge Disease Theories

Medical literature has documented exceptionally rare cases of endometriosis in biological males, with fewer than 20 instances recorded in clinical history. This condition, typically associated with individuals possessing a uterus and ovaries, involves endometrial-like tissue growing in unusual locations such as the bladder or abdominal wall. Such occurrences present a biological anomaly that prompts a reevaluation of traditional theories on endometriosis origin and spread.

The leading theory suggests that remnants of embryonic Mullerian ducts can become reactivated. This reactivation is thought to be triggered by hormonal influences, particularly elevated estrogen levels. Many documented male cases involved men undergoing extended estrogen therapy for prostate cancer or those with severe liver cirrhosis, which impairs estrogen metabolism. These hormonal shifts may induce the transformation of vestigial embryonic cells into endometrial-type tissue.

Despite its extreme rarity, male endometriosis can manifest with symptoms mirroring those seen in females, including severe cramping, persistent abdominal pain, and bloating. These unusual cases offer invaluable insights into the complex interplay of hormones and genetics in endometriosis development across diverse populations, underscoring the need for broader understanding of the disease.