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In this case report, we present a case of a woman in her 30s who was diagnosed with thoracic endometriosis presenting as a large pulmonary mass. Hormonal treatment progestin (synthetic form of progesterone) was started. The patient was deemed technically inoperable due to anatomical constraints.Follow-up CT showed little change in the lesion’s size but revealed central cavitation within the lesion due to its connection to a posterobasal bronchus presenting an additional therapeutic dilemma.This case highlights the diagnostic and treatment challenges associated with atypical thoracic masses that mimic malignant tumours particularly in the context of inoperable patients.