Catamenial Pneumothorax: a Case Report and Review of the Literature

Abstract

Catamenial pneumothorax is a rare condition that is often misdiagnosed. It is defined as spontaneous pneumothorax occuring within 72 hours before or after onset of menstruation. Etiology is unknown but could be linked to endometriosis. Treatment is medicosurgical: thoracoscopy for pleural abrasion and hormonotherapy to avoid recurrence.

Case report: catamenial pneumothorax

“…Findings CXR Pneumothorax ± Ground-glass haze in lung base/pleural CT scan Pneumothorax and ground-glass nodular lesion in subpleural location MRI scan Pneumothorax and Ground-glass pleural lesion with blood which appears hyperintense on T2-weighted imaging during menstruation Histopathological findings of catamenial pneumothorax may include: endometrial glands and stroma, haemosiderin-ladden macrophages, other inflammatory cells, pulmonary blebs, or fibrosis 21,22 . Although histological confirmation provides definitive evidence of thoracic endometriosis, endometrial tissue may be absent on histology due to technical difficulties in sampling and the avoidance of diaphragmatic perforation 22,23,24 . The approach to managing of catamenial pneumothorax is multi-faceted often involving a respiratory physician, thoracic surgeon, gynaecologist, radiologist and histopathologist 3,6,10,13,14 .…”

“…They are associated with recurrence rates of 40% and 32% respectively 13 . In patients with suspected high risk of recurrence, hormonal suppression should be considered 24,28 .…”