Catamenial pneumothorax: Presentation of an uncommon Pathology

Roger Haddad, Rui Haddad, Caterin Arévalo, David Nigri
In: Archives of Case Reports · 2017 · vol. 1(1) , pp. 009–013 · doi:10.29328/journal.hjcr.1001004 · W2781609075
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes catamenial pneumothorax, an uncommon pathology associated with thoracic endometriosis, detailing a successful treatment involving pleurodesis, diaphragmatic mesh, and hormonal therapy for a 38-year-old female.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper describes catamenial pneumothorax and reports a case of a 38-year-old woman who had abdominal endometriosis, was receiving hormone therapy, and experienced repetitive pneumothorax. Using video-assisted thoracoscopy, the authors observed diaphragmatic lesions and pneumothorax in the perioperative and postoperative period, and they highlight detailed inspection of intrathoracic organs during surgery; they report that intraoperative pleurodesis, diaphragmatic mesh placement, and continuation of hormonal treatment were used to prevent recurrences. The main limitation is that the evidence presented is based on a single case report, so broader generalizability is not established. Relevance to endometriosis: the paper focuses on catamenial pneumothorax and emphasizes its strong association with thoracic endometriosis syndrome, including a clinical case in a patient with abdominal endometriosis and thoracic manifestations.

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Abstract

The catamenial pneumothorax is defined as the accumulation of air in the pleural cavity that appears in women infrequently and spontaneously with various clinical presentations. Actually, it is considered as an extremely rare entity with few cases described in the literature, that is the reason why the etiology is still discussed. However, a strong association with thoracic endometriosis syndrome has been found. We want to emphasize how the importance of conducting a diagnosis and having a timely management would improve the quality of life of the patient and give a better prognosis of the disease. Thus, a case report of a 38-year-old female patient who was receiving hormone therapy as a treatment for abdominal endometriosis and repetitive pneumothorax was presented. In the video-assisted thoracoscopy we saw diaphragmatic lesions and pneumothorax during the perioperative and postoperative period. Emphasize the importance of a detailed inspection of each intrathoracic organ during the surgical procedure, we also showed how the intraoperative pleurodesis, the placement of a mesh on the diaphragm and the continuity of the hormonal treatment, seems to be an effective therapy to prevent recurrences and have a better control of the disease.
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Catamenial pneumothorax: Presentation of an uncommon Pathology Main Article Content Abstract The catamenial pneumothorax is defined as the accumulation of air in the pleural cavity that appears in women infrequently and spontaneously with various clinical presentations. Actually, it is considered as an extremely rare entity with few cases described in the literature, that is the reason why the etiology is still discussed. However, a strong association with thoracic endometriosis syndrome has been found. We want to emphasize how the importance of conducting a diagnosis and having a timely management would improve the quality of life of the patient and give a better prognosis of the disease. Thus, a case report of a 38-year-old female patient who was receiving hormone therapy as a treatment for abdominal endometriosis and repetitive pneumothorax was presented. In the video-assisted thoracoscopy we saw diaphragmatic lesions and pneumothorax during the perioperative and postoperative period. Emphasize the importance of a detailed inspection of each intrathoracic organ during the surgical procedure, we also showed how the intraoperative pleurodesis, the placement of a mesh on the diaphragm and the continuity of the hormonal treatment, seems to be an effective therapy to prevent recurrences and have a better control of the disease. Article Details Copyright (c) 2017 Haddad R, et al. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Maurer ER, Schaal JA, Mendez FL. Chronic recurring spontaneous pneumothorax due to endometriosis of the diaphragm. J Am Med Assoc.1958; 168: 2013-2014. Ref.: https://goo.gl/FiyN2b Slabbynck H, Laureys M, Impens N, DeVroey P, Schandevyl W. Recurring catamenial pneumothorax treated with a Gn-RH analogue. Chest. 1991; 100: 851. Ref.: https://goo.gl/vJAPTL Giudice LC, Kao LC. Endometriosis. Lancet. 2004; 364: 1789-1799. Ref.: https://goo.gl/HPPbZF Azizad-Pinto P, Clarke D. Thoracic endometriosis syndrome: case report and review of the literature. Perm J. 2014; 18: 61-65. Ref.: https://goo.gl/uChURZ Alifano M, Trisolini R, Cancellieri A, Regnard JF. Thoracic endometriosis: Current knowledge. Ann Thorac Surg. 2006; 81: 761-769. Ref.: https://goo.gl/7WAFgy Tettey M, Edwin F, Aniteye E, Seffah J, Tamatey M, et al. Thoracic endometriosis syndrome. West Afr J Med. 2013; 32: 302-306. Ref.: https://goo.gl/SSxuGb Joseph J, Sahn SA. Thoracic endometriosis syndrome: New observations from an analysis of 110 cases. Am J Med. 1996; 100: 164-170. Ref.: https://goo.gl/iPucCc Van Schil PE, Vercauteren SR, Vermeire PA, Nackaerts YH, Van Marck EA. Catamenial pneumothorax caused by thoracic endometriosis. Ann Thorac Surg. 1996; 62: 585-586. Ref.: https://goo.gl/iiS4Jw Sampson JA. Metastatic or embolic endometriosis, due to the menstrual dissemination of endometrial tissue into the venous circulation. Am J Pathol. 1927; 3: 93-110. Ref.: https://goo.gl/8DmJEM Joseph J, Reed CE, Sahn SA. Thoracic endometriosis: Recurrence following hysterectomy with bilateral salpingo-oophorectomy and successful treatment with talc pleurodesis. Chest. 1994; 106: 1894-1896. Ref.: https://goo.gl/H98s4Y Kumakiri J, Kumakiri Y, Miyamoto H, Kikuchi I, Arakawa A, et al. Gynecologic Evaluation of Catamenial Pneumothorax Associated with Endometriosis. J Minim Invasive Gynecol. 2010; 17: 593-599. Ref.: https://goo.gl/Jy2HKZ Rousset-Jablonski C, Alifano M, Plu-Bureau G, Camilleri-Broet S, Rousset P, et al. Catamenial pneumothorax and endometriosis-related pneumothorax: Clinical features and risk factors. Hum Reprod. 2011; 26: 2322-2329. Ref.: https://goo.gl/SKjzSZ L’huillier JP, Salat-Baroux J. [A patient with pulmonary endometriosis]. Rev Pneumol Clin. 2002; 58: 233-236. Ref.: https://goo.gl/1q9PnM Nezhat C, Main J, Paka C, Nezhat A, Beygui RE. Multidisciplinary Treatment for Thoracic and Abdominopelvic Endometriosis. JSLS. 2014; 18. Ref.: https://goo.gl/AkU1gA Korom S, Canyurt H, Missbach A, Schneiter D, Kurrer MO, et al. Catamenial pneumothorax revisited: Clinical approach and systematic review of the literature. J Thorac Cardiovasc Surg. 2004. 128: 502-508. Ref.: https://goo.gl/so5yfR Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014; 10: 261-275. Ref.: https://goo.gl/Y6HMBr Nair SS, Nayar J. Thoracic Endometriosis Syndrome: A Veritable Pandora’s Box. J Clin Diagn Res. 2016; 10. Ref.: https://goo.gl/ARgA3Q

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