Abstract

Pneumothorax or hemoptysis that recurs with the onset of menses (ie, catamenial) is strongly supportive of thoracic endometriosis syndrome (TES), which arises as a consequence of ectopic endometrial tissue localized outside the pelvis. In this issue of the Southern Medical Journal, Arunthari et al¹ report a 44-year-old woman who presented with recurrent right-sided pneumothoraces and a palpable umbilical nodule. After a detailed history was obtained, it was determined that her pneumothoraces, as well as cyclical recurrent symptoms of right shoulder and right upper chest discomfort, were temporally associated with the onset of menses. The catamenial nature of her presentation was suggestive of TES, and subsequent operative evaluation confirmed the presence of endometrial tissue localized to the abdominal surface of the right hemidiaphragm; the umbilical nodule was also found to be an endometrioma. She was treated with hysterectomy and bilateral salpingo-oophorectomy, and after 12 months of follow-up has had no recurrence of her symptoms.