Thoracic endometriosis as cause of recurrent pneumothorax.
We present a 44-year-old woman with no personal history of relevance but for a heterozygous mutation G1691A of the gene of Leiden factor V. Her history starts 2 years ago with two consecutive, 1 month apart, right pneumothoraces that were diagnosed as primary spontaneous pneumothorax (PSP). In both cases she was treated with endopleural aspiration and respiratory physical therapy, with full recovery.

The patient remained asymptomatic for a year, but she suffered another right spontaneous pneumothorax (Figure 1). She was treated with endopleural aspiration. Videothoracoscopy was performed and revealed a bullae in the inferior lobe, a fibroid plaque on the posterior thoracic wall and a hypervascularized lesion with multiple fenestrations localized at the diaphragmatic pleura. A biopsy was taken from the hypervascularized lesion and showed pleural with fibrosis with a hyperplasic mesothelial reaction. Resection of the bullae and pleural abrasion were performed. 



Figure 1. 
Chest radiograph showing a right-sided pneumothorax.



The next year the patient suffered her fourth episode of spontaneous pneumothorax and was treated again with endopleural aspiration and respiratory physical therapy. After 1 …