[Catamenial pneumothorax]

We report 3 cases of catamenial pneumothorax, with review of the literatures. Case 1: A 38-year-old female had recurrent right-sided pneumothorax in February 2001. Videothoracoscopic visualization showed multiple small fenestrations in central tendon of diaphragm. A partial diaphragmatic resection including the lesions was performed. She received hormone therapy postoperatively. Case 2: A 40-year-old female with past history of ovarian endometriosis had recurrent right-sided pneumothorax in 1993. During the operation, multiple diaphragmatic fenestrations and bullae of right middle and lower lobes were identified. The lesions were resected and postoperative hormone therapy was performed for 6 months. In 1997, right-sided pneumothorax recurred. She underwent surgical procedure due to prolonged air leakage from the right lung. During the operation, a diaphragmatic fenestration and bulla of apex of right upper lobe of the lung were visualized. Diaphragm was reefed and bulla was resected. After that, she had no recurrence of pneumothorax. Case 3: A 39-year-old female had recurrent right-sided pneumothorax in 2003. Under video-assisted thoracoscopic surgery, multiple fenestrations of central tendinous diaphragm were identified. Diaphragmatic partial resection was performed. Postoperatively, she received hormone therapy for 6 months. After hormone therapy, she suffered from recurrent pneumothorax, and underwent an operation. During the operation, she had endometriosis of visceral pleura without diaphragmatic fenestration. Once again, she received postoperative hormone therapy. Catamenial pneumothorax is a rare disease, and the definite etiology has not been clarified. A combination of both surgical and hormone therapy is useful for treatment.