Thoracic endometriosis presenting as hemopneumothorax

Submitted: August 9, 2022
Accepted: September 23, 2022
Published: September 28, 2022
Abstract Views: 1040
PDF: 251
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Thoracic endometriosis is very rare. Usually, the thorax is the most frequent affected site outside the pelvis. Common symptoms include chest pain, dyspnea, and hemoptysis. Common manifestations include pneumothorax, hemothorax, and pulmonary or pleural nodules. In addition, symptoms and manifestations can be “catamenial” happening a few days after menstruation onset. This disease can be debilitating, causing a significant impact on the quality of life of young women. We present a case of a young female who was referred to our hospital with recurrent right-sided pleural effusions and pneumothoraces. Pleural fluid drainage was consistent with hemothorax. Transvaginal ultrasound showed mild intraperitoneal fluid in the Cul-de-Sac. Due to concerns for thoracic endometriosis, video-assisted thoracoscopic surgery was performed confirming the diagnosis by pathology. Therapeutic pleurectomy with diaphragmatic repair and pleurodesis was performed. The patient was started on medroxyprogesterone acetate injections two weeks after with great clinical response.



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Nezhat C, Lindheim SR, Backhus L, et al. Thoracic endometriosis syndrome: A review of diagnosis and management. JSLS 2019;23:e2019.00029. DOI:
Joseph J, Sahn SA. Thoracic endometriosis syndrome: new observations from an analysis of 110 cases. Am J Med 1996;100:164-70. DOI:
Fukuda S, Hirata T, Neriishi K, et al. Thoracic endometriosis syndrome: Comparison between catamenial pneumothorax or endometriosis-related pneumothorax and catamenial hemoptysis. Eur J Obstet Gynecol Reprod Biol 2018;225:118-23. DOI:
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:
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. DOI:
Attaran S, Bille A, Karenovics W, Lang-Lazdunski L. Videothoracoscopic repair of diaphragm and pleurectomy/abrasion in patients with catamenial pneumothorax: a 9-year experience. Chest 2013;143:1066-9. DOI:
Korom S, Canyurt H, Missbach A, et al. Catamenial pneumothorax revisited: clinical approach and systematic review of the literature. J Thorac Cardiovasc Surg 2004;128:502-8. DOI:
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:
Soares T, Oliveira MA, Panisset K, et al. Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treat. Horm Mol Biol Clin Investig 2021;43:137-43. DOI:
Guo SW, Wang Y. The prevalence of endometriosis in women with chronic pelvic pain. Gynecol Obstet Invest 2006;62:121-30. DOI:
Nair SS, Nayar J. Thoracic endometriosis syndrome: A veritable Pandora's box. J Clin Diagn Res 2016;10:QR04-8. DOI:
Nezhat C, Main J, Paka C, et al. Multidisciplinary treatment for thoracic and abdominopelvic endometriosis. JSLS 2014;18:e2014.00312. DOI:
Wang HC, Kuo PH, Kuo SH, Luh KT. Catamenial hemoptysis from tracheobronchial endometriosis: reappraisal of diagnostic value of bronchoscopy and bronchial brush cytology. Chest 2000;118:1205-8. DOI:

How to Cite

El Haj Chehade, Ahel, Ahmad Basil Nasir, Jo Elle G. Peterson, Timothy Ramseyer, and Himanshu Bhardwaj. 2022. “Thoracic Endometriosis Presenting As Hemopneumothorax”. Monaldi Archives for Chest Disease 93 (3).