Thoracic Endometriosis-A Case Report and Literature Review

Hemoptysis can be caused by a variety of pulmonary diseases, including infection, cardiovascular disorders, systemic disorders, trauma and malignancy. If it recurs and correlates with the time of menstruation in a pre-menopausal woman, a diagnosis of thoracic endometriosis should be highly suspected. We report the case of 49-year-old woman who presented with recurrent episodes of hemoptysis and dyspnea, coincident with the time of menstruation, for 1 year. Chest X-ray and computed tomography (CT) yielded significant right-sided hydropneu-mothorax. Thoracentesis revealed bloody pleural effusion. An elevated tumor marker cancer antigen-125 (CA-125) level was noted. Chest echo-guided pleural biopsy and thoracotomy led to a diagnosis of endometriosis. The patient underwent decortication of the right involved pleura and received danazol (Ladogal®) treatment after surgery. No recurrence of hemoptysis was noted during 6 months of follow-up. In this report, we also review the various presentations, pathogeneses and therapies of thoracic endometriosis, and discuss the role of CA-125 in thoracic endometriosis.