Catamenial Hemoptysis Secondary to Giant Mediastinal Endometriosis with Pericardial Involvement. A Case Report of Thoracic Endometriosis Syndrome.

Catamenial hemoptysis with mediastinal and pericardial involvement is a rare presentation of Thoracic Endometriosis Syndrome (TES) which is seldom proven via histopathology.  TES is a clinical manifestation of the presence of endometrial tissue within the thorax cavity. Typically, it is being described as consisted of 4 components including catamenial pneumothorax, hemothorax, hemoptysis and pulmonary nodules1. Some even suggested to include catamenial chest pain, pleural effusion and even diaphragmatic hernia2. The pathophysiology of TES still is being debated and often considered as multifactorial3. The basis of the theory behind pathophysiology of TES is based on their clinical presentation and predominance characteristics and hence the description of variety presentation of TES is important to be documented as it will help us to develop more understanding regarding this syndrome. We reported a case of catamenial hemoptysis secondary to large anterior mediastinal endometriosis with radiological, operative imaging and histopathological evidence of mediastinal and pericardial involvement.