Catamenial hemothorax: a perplexing tale of unilateral hemothorax

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This case report describes a 36-year-old female with recurrent right-side pleural effusion caused by catamenial hemothorax, a manifestation of thoracic endometriosis syndrome.

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This paper reports a case of catamenial hemothorax, a manifestation of thoracic endometriosis syndrome, in a 36-year-old woman who presented with recurrent right-sided pleural effusion occurring in relation to menstrual cycles. The authors emphasize that establishing a menstrual cycle correlation with symptoms is necessary for diagnosis. Key finding is the clinical characterization of recurrent unilateral hemothorax as thoracic endometriosis syndrome (catamenial hemothorax) rather than another cause of pleural effusion. As a single case report, it provides limited generalizability and does not establish broader causal mechanisms. This paper is centrally about endometriosis — it describes catamenial hemothorax as a thoracic endometriosis syndrome manifestation with recurrent pleural effusion linked to menstruation.

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Abstract

The clinical entity in which functional endometrial tissue is present in the thoracic cavity causing various clinical manifestations is called thoracic endometriosis syndrome (TES). Catamenial hemothorax (CHt) is a clinical manifestation of TES characterized by recurrent hemothorax which occurs during each menstrual cycle. The establishment of a correlation between menstrual cycle and clinical features is necessary for the diagnosis. We report a case of CHt in a 36-year-old female who presented with recurrent right-side pleural effusion.
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Abstract

The clinical entity in which functional endometrial tissue is present in the thoracic cavity causing various clinical manifestations is called thoracic endometriosis syndrome (TES). Catamenial hemothorax (CHt) is a clinical manifestation of TES characterized by recurrent hemothorax which occurs during each menstrual cycle. The establishment of a correlation between menstrual cycle and clinical features is necessary for the diagnosis. We report a case of CHt in a 36-year-old female who presented with recurrent right-side pleural effusion. Similar content being viewed by others Data availability Data regarding study is available with the corresponding author. Data will be provided at request.

References

Chetambath R, Kumar P, Nandini V, Chandran S, Chacko A. Catamenial haemothorax—a rare cause of pleural effusion. Lung India. 2023;40:541–4. Nezhat C, Lindheim SR, Backhus L, Vu M, Vang N, Nezhat A, et al. Thoracic endometriosis syndrome: a review of diagnosis and management. JSLS: J Soc Laparoendosc Surg. 2019;23:e2019.00029. Adesanya OA, Kolawole OE. Thoracic endometriosis syndrome: cutting the gordian knot–a case report and review of the literature. Int J Surg Case Rep. 2020;1:68–71. Fukuda S, Hirata T, Neriishi K, Nakazawa A, Takamura M, Izumi G, et al. Thoracic endometriosis syndrome: comparison between catamenial pneumothorax or endometriosis-related pneumothorax and catamenial hemoptysis. Eur J Obstet Gynecol Reprod Biol. 2018;1:118–23. Ahmed A, Garba I, Denue BA, Alkali MB, Bakki B, Rawizza H. Catamenial right haemothorax due to endometriosis: two case reports. Afr J Respir Med. 2015;10:24–26. Velagapudi RK, Egan JP. Thoracic endometriosis: a clinical review and update of current and evolving diagnostic and therapeutic techniques. Curr Pulmonol Rep. 2021;10:22–9. Azizad-Pinto P, Clarke D. Thoracic endometriosis syndrome: case report and review of the literature. Permanente J. 2014;18:61. Funding None. Author information Authors and Affiliations Corresponding author Ethics declarations Ethics approval This case report does not require ethical approval. Consent was taken from the patient for publishing data. Animal rights statement Not applicable. Human rights statement The authors assert that all procedures contributing to this study comply with the ethical standards of the relevant national guidelines and with the Declaration of Helsinki 1975, as revised in 2008. Conflict of interest The authors have not received any funding or benefits from industry or elsewhere to conduct this study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Yoganadhan, P.P., Radhakrishnan, R., Babu, A. et al. Catamenial hemothorax: a perplexing tale of unilateral hemothorax. Indian J Thorac Cardiovasc Surg 41, 318–320 (2025). https://doi.org/10.1007/s12055-024-01791-w Received: Revised: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s12055-024-01791-w

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