040 * JUVENILE CATAMENIAL PNEUMOTHORAX: AN INSTITUTIONAL REPORT AND REVIEW

Objectives: Catamenial pneumothorax (CP) is classified as a part of the thoracic endometriosis syndrome, represents 3–6% of spontaneous pneumothorax cases in menstruating women, and usually involves the right side of the thorax (85–95%). Many patients show diaphragm lesions, which may occur because the endometrial tissue migrates through the diaphragm. However, currently, few studies have reported on CP in young women. We defined juvenile CP (JCP) as CP in <20-year-olds and performed a systematic literature review on CP using our institutional findings and those in previous studies. Methods: We enrolled all patients with CP treated at our institutions from January 2002 to June 2013 and conducted a search of the medical literature on CP. Results: We examined the records of 13 female patients with CP (mean age, 40.2 ± 9.0 years, range 18–53 years); CP was noted on the right, left, and both sides in 11, 1, and 1 case, respectively, treated at our institutions. Only 1 patient with left-side CP was classified as JCP. Our literature review identified 29 cases of JCP, and we included these in our analysis. JCP occurred more frequently on the left side than CP in older patients (right 14, left 16; 412 vs 27; P < 0.01), and significantly fewer JCP patients presented with diaphragm lesions than older patients (16.7% vs 86.0%,P < 0.01). Conclusion: CP showed no laterality and had fewer diaphragm lesions in juvenile cases than in older patients. Accordingly, JCP may have a different mechanism of action and may represent a separate entity to CP.