Thoracic endometriosis presenting with bilateral haemothoraces: a rare but important cause of bilateral pleural effusions

Chanaka Dinesh Rathnayake, Rathnayake CD, Zaheer SA, Syeda Aisha Zaheer, Williams C, Clare Williams, Manjuvani Neerudu, Neerudu M
BMJ case reports · 2026 · vol. 19(7) , pp. e273472 · doi:10.1136/bcr-2026-273472 · PMID:42448435 · W7168279511
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This case describes a woman treated for recurrent hemorrhagic pleural effusions confirmed as thoracic endometriosis after thoracoscopic biopsy, with resolution following hormonal therapy.

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Abstract

A woman in her 30s was admitted with 6 months of progressive shortness of breath and cyclical bilateral pleuritic chest pain associated with heavy, painful menstruation. She had a history of endometriosis. Chest X-ray revealed a large right pleural effusion requiring several aspirations. The pleural aspirate was haemorrhagic. Cytology revealed no malignant cells. CT thorax-abdomen-pelvis did not reveal any lung masses or pleural abnormalities. Pelvic MRI showed multiple uterine fibroids and a few simple left ovarian cysts. She re-presented a few months later with bilateral effusions, worse on the right than the left. The right required an intercostal drain. The left pleural aspirate was haemorrhagic, and cytology was the same as the right. She underwent right video-assisted thoracoscopic surgery directed pleural biopsies and diaphragmatic excision. Histology revealed endometrial tissue, confirming thoracic endometriosis. She was started on oral contraception, leading to resolution of the effusions.

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MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (11)

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