Catamenial Pneumothorax: Report of a Case

Catamenial pneumothorax is a rare disease, with only over two hundred cases reported since 1958. Its exact cause is still unknown, though many etiologies have postulated. We present a 37-year-old non-smoking female whose menstruation was concurrent with recurrent right-sided spontaneous pneumothorax. Computed-tomography of the chest showed right-sided pneumothorax. At thoracoscopy, multiple fenestrations were revealed on the tendinous part of the right hemidiaphragm. They were resected and repaired for pathological studies. Microscopic findings revealed mesothelial cells lining around the fenestrations. No endometrial gland was found. We will describe and discuss the hypotheses of etiologies in our report. The treatment of catamenial pneumothorax is controversial, including surgery, tube thoracotomy, fallopian tube ligation and hormonal therapy. Surgical intervention together with hormonal therapy remains the most effective way and conforms to the principle of treatment.