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Case report
Refractory thoracic endometriosis
  1. Nishant Sharma1,
  2. Pandi Todhe1,
  3. Pius Ochieng2 and
  4. Srinivasarao Ramakrishna2
  1. 1Department of Internal Medicine, Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA
  2. 2Department of Pulmonary/Critical Care, Geisinger Community Medical Center, Scranton, Pennsylvania, USA
  1. Correspondence to Dr Nishant Sharma; doctornsharma{at}


Thoracic endometriosis syndrome (TES) is a rare entity caused by thoracic implantation of endometrial tissue, manifesting as catamenial pneumothorax, pleural effusion and haemoptysis in young female individuals. Its management and long-term prevention of recurrences, can be challenging. We present the case of a young woman who presented with recurrent pneumothorax, haemopneumothorax and pleural effusion. The diagnosis of TES was confirmed based on cytological findings of pleural fluid. She underwent treatment with mechanical pleurodesis twice but continued to have recurrences. Hormonal treatment failed to produce a satisfactory resolution. She underwent chemical pleurodesis, which successfully induced remission of her TES. A review of the literature suggests that chemical pleurodesis produces better results compared with mechanical pleurodesis and that hormonal treatment with gonadotropin-releasing hormone agonists is effective at preventing recurrences.

  • respiratory medicine
  • pneumothorax
  • cardiothoracic surgery

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  • Contributors NS wrote the case presentation and the case discussion. PT and PO assisted in literature review and writing the case discussion section. SR provided oversight of the process, and reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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