Catamenial Pneumothorax due to Suspected Thoracic Endometriosis Syndrome in a Woman with Adenomyosis and Cystoma Ovarii

Catamenial Pneumothorax due to Suspected Thoracic Endometriosis Syndrome in a Woman with Adenomyosis and Cystoma Ovarii DOI: https://doi.org/10.21776/ub.jkb.2025.033.03.10Keywords: Catamenial pneumothorax, thoracic endometriosis syndromeAbstract Catamenial pneumothorax (CP) is a recurrent spontaneous pneumothorax during the menstruation period and is often associated with thoracic-pelvic endometriosis. This case study reported a 39-year-old woman who presented with recurrent shortness of breath, particularly during menstruation. The patient also experienced severe dysmenorrhea and difficulty getting pregnant. Despite a negative sputum test, a history of chest tube insertion and tuberculosis treatment were identified. Elevated levels of the CA-125 marker were observed in a previous examination. Physical examination revealed decreased fremitus sounds on the mediobasal side, chest expansion, and right lung breath sounds. The plain radiograph displayed a visceral pleural line, air-fluid level appearance, and the collapse of the right hemithorax accompanied by fibrosis. The patient underwent inpatient treatment and had a chest tube inserted. A decortication thoracotomy procedure was performed, and anatomical pathology microscopic examination of the right lung tissue revealed a non-specific chronic inflammatory process accompanied by fibrosis. Downloads References 1. Ciriaco P, Muriana P, Carretta A, Ottolina J, Candiani M, and Negri G. Catamenial Pneumothorax as the First Expression of Thoracic Endometriosis Syndrome and Pelvic Endometriosis. Journal of Clinical Medicine. 2022; 11(5): 1-10. 2. Nezhat C, Lindheim SR, Backhus L, et al. Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management. JSLS: Journal of the Society of Laparoendoscopic & Robotic Surgeons. 2019; 23(3): 1-8. 3. Nair SS and Nayar J. Thoracic Endometriosis Syndrome: A Veritable Pandora's Box. Journal of Clinical and Diagnostic Research: JCDR. 2016; 10(4): QR04-QR08. 4. Visouli AN, Zarogoulidis K, Kougioumtzi I, et al. Catamenial pneumothorax. Journal of Thoracic Disease. 2014; 6(Suppl 4): S448-S460. 5. Gil Y and Tulandi T. Diagnosis and Treatment of Catamenial Pneumothorax: A Systematic Review. Journal of Minimally Invasive Gynecology. 2020; 27(1): 48-53. 6. Furuta C, Yano M, Numanami H, Yamaji M, Taguchi R, and Haniuda M. Nine Cases of Catamenial Pneumothorax: A Report of a Single-Center Experience. Journal of Thoracic Disease. 2018; 10(8):4801-4805. 7. Maniglio P, Ricciardi E, Meli F, et al. Catamenial Pneumothorax Caused by Thoracic Endometriosis. Radiology Case Reports. 2018; 13(1): 81-85. 8. Azizad-Pinto P and Clarke D. Thoracic Endometriosis Syndrome: Case Report and Review of the Literature. The Permanente Journal. 2014; 18(3): 61-65. 9. Ichiki Y, Nagashima A, Yasuda M, Takenoyama M, and Toyoshima S. Surgical Treatment of Catamenial Pneumothorax: Report of Three Cases. Asian Journal of Surgery. 2015; 38(3): 180-185. 10. Ciriaco P, Muriana P, Lembo R, Carretta A, and Negri G. Treatment of Thoracic Endometriosis Syndrome: A Meta-Analysis and Review. The Annals of Thoracic Surgery. 2022; 113(1): 324-336. 11. Choi EJ, Cho SB, Lee SR, Lim YM, et al. Comorbidity of Gynecological and Non-Gynecological Diseases with Adenomyosis and Endometriosis. Obstetrics & Gynecology Science. 2017; 60(6): 579-586. 12. Kramer AW and Bautista M. Catamenial Pneumothorax in a 14-Year-Old Female: A Case Report and Literature Review. Respiratory Medicine Case Reports. 2019; 28: 1-3. 13. Mulkey ET, Stewart GD, Ismael M, and Lewis C. A Case Report of Recurrent Spontaneous Pneumothorax Secondary to Thoracic Endometriosis Syndrome. American Journal of Medical Case Reports. 2021; 9(11): 548-551. 14. Elia S, De Felice L, Varvaras D, Sorrenti G, Mauriello A, and Petrella G. Catamenial Pneumothorax due to Solitary Localization of Diaphragmatic Endometriosis. International Journal of Surgery Case Reports. 2015; 12: 19-22. 15. Soares T, Oliveira MA, Panisset K, et al. Diaphragmatic Endometriosis and Thoracic Endometriosis Syndrome: A Review on Diagnosis and Treatment. Hormone Molecular Biology and Clinical Investigation. 2021; 43(2): 137-143. 16. Rousset P and Revel MP. Re: Thoracic Endometriosis Syndrome: CT and MRI Features. A Reply. Clinical Radiology. 2014; 69(5): 549-550. 17. Farghaly SA. Current Diagnosis and Management of Ovarian Cysts. Clinical and Experimental Obstetrics & Gynecology. 2014; 41(6): 609-612. 18. Hwang SM, Lee CW, Lee BS, and Park JH. Clinical Features of Thoracic Endometriosis: A Single Center Analysis. Obstetrics & Gynecology Science. 2015; 58(3): 223-231. 19. Alifano M, Roth T, Broe SC, Schussler O, Magdeleinat P, Regnard JF. Catamenial Pneumothorax: A Prospective Study. Chest. 2003; 124(3): 1004-1008. 20. Tulandi T, Sirois C, Sabban H, et al. Relationship between Catamenial Pneumothorax or Non-Catamenial Pneumothorax and Endometriosis. Journal of Minimally Invasive Gynecology. 2018; 25(3): 480-483. 21. Ghigna MR, Mercier O, Mussot S, Fabre D, Fadel E, Dorfmuller P, de Montpreville VT. Thoracic Endometriosis: Clinicopathologic Updates and Issues About 18 Cases from a Tertiary Referring Center. Annals of Diagnostic Pathology. 2015; 19(5): 320-325. 22. Kawaguchi Y, Hanaoka J, Ohshio Y, et al. Diagnosis of Thoracic Endometriosis with Immunohistochemistry. Journal of Thoracic Disease. 2018; 10(6): 3468-3472. 23. Marjański T, Sowa K, Czapla A, and Rzyman W. Catamenial Pneumothorax–A Review of the Literature. Kardiochirurgia i Torakochirurgia Polska (Polish Journal of Thoracic and Cardiovascular Surgery). 2016; 13(2): 117-121. 24. Okafor OC, Ezemba N, Onyishi NT, and Ezike KN. Improving the Diagnostic Recognition of Thoracic Endometriosis: Spotlight on a New Histo-Morphological Indicator. PLoS One. 2021; 16(5): 1-15. 25. Chen Y, Zhu HL, Tang ZW, et al. Evaluation of Circulating Endometrial Cells as a Biomarker for Endometriosis. Chinese Medical Journal. 2017; 130(19): 2339-2345. 26. Mecha E, Makunja R, Maoga JB, et al. The Importance of Stromal Endometriosis in Thoracic Endometriosis. Cells. 2021; 10(1): 1-13. 27. Chen X, Tang J, Shuai W, Meng J, Feng J, and Han Z. Macrophage Polarization and Its Role in the Pathogenesis of Acute Lung Injury/Acute Respiratory Distress Syndrome. Inflammation Research. 2020; 69(9): 883-895. 28. Bricelj K, Srpčič M, Ražem A, and Snoj Ž. Catamenial Pneumothorax Since Introduction of Video-Assisted Thoracoscopic Surgery: A Systematic Review. Wiener Klinische Wochenschrift. 2017; 129(19-20): 717-726. Downloads Published Issue Section License Copyright (c) 2025 Jurnal Kedokteran Brawijaya This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. 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