Thoracic Endometriosis - Report of Two Rare Cases

Abstract

Thoracic endometriosis syndrome (TES) is a group of diseases caused by ectopic endometrial tissue in the thoracic cavity in women of child bearing age. This extremely rare condition is difficult to diagnose, unless direct correlation with menstrual cycle is established. The syndrome consists of pleural form such as catamenial pneumothorax, non-catamenial endometriosis-related pneumothorax and haemothorax; and parenchymal form such as catamenial haemoptysis and lung nodules. Symptoms are typically cyclical and recurrent, with a right-sided predominance. Computed tomography (CT) is the first-line imaging method, but is poorly specific; therefore, its main role is to rule out other pulmonary diseases. However, in women with a typical clinical history, some key CT findings may help to confirm this syndrome. MRI can also assist with the diagnosis, by showing signal changes typical of haemorrhage within diaphragmatic or pleural lesions. Here we present two cases of pleural forms of endometriosis one presenting as haemothorax and the other as recurrent pneumothorax. Both these presentations are very rare. Key words: Catamenial, endometriosis, haemothorax