A CASE OF CATAMENIAL PNEUMOTHORAX WITH ENDOMETRIOSIS IN THE VISCERAL PLEURA

The paper reports a rare case of catamenial (menstruation-associated) pneumothorax in a 39-year-old woman with suspected visceral pleural endometriosis. The patient presented with dyspnea and was diagnosed with a right pneumothorax after a prior conservatively treated episode that also occurred in the same relation to the menstrual cycle; because CT showed emphysematous changes at the right lung apex, video-assisted thoracoscopic surgery was performed. Intraoperatively, the authors found a dark brown cyst-like elevation in the lung apex and multiple small diaphragmatic holes, leading them to resect the apical lesion but to abort broad excision and instead perform sutured closure; pathology did not identify endometrial tissue, but showed hemosiderin deposition and small bleeding lesions suggestive of indirect endometrial bleeding. Hormonal therapy with buserelin acetate was started for recurrence prevention, and no recurrence was reported at follow-up, though it is a single case report and cannot establish causality. This paper is centrally about endometriosis — it describes catamenial pneumothorax with endometriosis-like lesions on the visceral pleura.

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