Solomon Gumanga^1,, Godfred Takyi¹, Hakeem Ofosu¹, Sunday Imogie¹, Bill Koomson¹

Catamenial haemothorax is a clinical manifestation of endometriosis of the pleural cavity. This is a case report of a 28 year old woman who presented with recurrent catamenial haemothorax who had histological confirmation of pelvic endometriosis and uterine leiomyoma. A presumptive diagnosis of catamenial haemothorax was made as it was not possible to get a histological confirmation of endometriosis of the pleural cavity. She was treated effectively with gonadotropin-releasing hormone GnRH agonist-leuprorelin. Antituberculosis treatment was however added when she developed empyema thoracis instead of haemothorax at a time she was experiencing amenorrhoea. Pulmonary tuberculosis being an endemic disease remained the main differential diagnosis but was never confirmed at any stage by investigations conducted. She has since not experienced any recurrence in eighteen months of follow-up after treatment was completed. Conclusion: Pulmonary or thoracic endometriosis though rare; should be considered seriously in women of reproductive age who present with recurrent catamenial haemothorax. Due to obscured locations of the endometriosis lesions in the thoracic cavity; the diagnosis may be difficult to confirm since access to investigative tools is limited in developing countries.

catamenial haemothorax, pulmonary endometriosis, thoracic endometriosis syndrome, extra pelvic endometriosis