Bilateral Catamenial pneumothorax with Catamenial Hemoptysis

R Narasimhan, C Selvi, C Govindasamy
In: Journal of Association of Pulmonologist of Tamil Nadu · 2019 · vol. 2(2) , pp. 69 · doi:10.4103/wkmp-0215.309242 · W4388130875
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This case report describes a 24-year-old female presenting with breathlessness, bilateral chest pain, and streaky hemoptysis that coincided with her menstrual cycle. Diagnostic imaging confirmed bilateral pneumothorax and elevated CA-125 levels, while videothoracoscopy revealed multiple nodules on the diaphragm. The patient underwent diaphragmatic meshplasty and talc pleurodesis, followed by hormonal therapy to prevent recurrence, resulting in clinical improvement over one year of follow-up. This paper is centrally about endometriosis — specifically thoracic endometriosis syndrome manifesting as catamenial pneumothorax and hemoptysis.

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Abstract

Bilateral catamenial pneumothorax coexisted with catamenial hemoptysis is a rare entity. It is usually caused by thoracic endometriosis syndrome. We report a case 24 year healthy female with no comorbid status presenting with bilateral catamenial pneumothorax with catamenial hemoptysis. This lady presented with breathlessness, bilateral chest pain and streaky hemoptysis for four months associated with her menstrual cycle. Chest x ray and CT chest done showed bilateral pneumothorax. Serum CA 125 levels was elevated. USG pelvis done was normal. Bronchoscopy was done in view of hemoptysis showed bilateral inflamed mucosa no active bleeding. Videothoracoscopy was done showed multiple nodules over the diaphragm, biopsy taken from that nodules following biopsy, diaphragmatic meshplasty and talc pleurodesis was done. To prevent the recurrence patient was started on hormonal therapy. Patient improved clinically and radiologically and no recurrence till one year of followup.
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Bilateral Catamenial pneumothorax with Catamenial Hemoptysis - C Selvi - C Govindasamy - R Narasimhan Bilateral catamenial pneumothorax coexisted with catamenial hemoptysis is a rare entity. It is usually caused by thoracic endometriosis syndrome. We report a case 24 year healthy female with no comorbid status presenting with bilateral catamenial pneumothorax with catamenial hemoptysis. This lady presented with breathlessness, bilateral chest pain and streaky hemoptysis for four months associated with her menstrual cycle. Chest x ray and CT chest done showed bilateral pneumothorax. Serum CA 125 levels was elevated. USG pelvis done was normal. Bronchoscopy was done in view of hemoptysis showed bilateral inflamed mucosa no active bleeding. Videothoracoscopy was done showed multiple nodules over the diaphragm, biopsy taken from that nodules following biopsy, diaphragmatic meshplasty and talc pleurodesis was done. To prevent the recurrence patient was started on hormonal therapy. Patient improved clinically and radiologically and no recurrence till one year of followup.

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