Catamenial Pneumothorax as the First Expression of Thoracic Endometriosis Syndrome and Pelvic Endometriosis

Abstract

Objective: The menstrual-related catamenial pneumothorax (CP) can be the first expression of thoracic endometriosis syndrome (TES), which is the presence of endometriotic lesions in the lungs and pleura, and pelvic endometriosis (PE). This study aims to analyze our experience with this specific correlation describing our multidisciplinary approach to CP. Methods: Hospital records of 32 women, operated for CP at our Department from January 2001 to December 2021 were reviewed. Surgical treatment consisted of videothoracoscopy and laparoscopy when indicated. Results: TES and PE were diagnosed in 13 (40.6%) and 12 (37.5%) women, respectively. The association of TES and PE was present in 11 cases (34%). Fifteen patients (46.9%) underwent laparoscopy, of which 11 concurrently with videothoracoscopy. Most of the patients affected had stage III–IV endometriosis (40.6%). All patients received hormonal therapy after surgery. Five patients with PE conceived spontaneously resulting in six live births. The mean follow-up was 117 ± 71 months (range 8–244). Pneumothorax recurrence occurred in six patients (18.8%). At present, all women are asymptomatic, with no sign of pneumothorax recurrence. Conclusions: CP might be the first expression of TES and/or PE. A multidisciplinary approach is advocated for optimal management of the disease.

Thoracic Endometriosis Syndrome (TES) in Martinique, a French West Indies Island

“…With regard to the medical history, 17.4% of our patients had no known history of pelvic endometriosis; this is not unusual, and indeed, higher rates have previously been reported elsewhere [18,29].…”

“…TES mainly occurs in the form of catamenial pneumothorax (CP), namely pneumothorax occurring during the perimenstrual period [4]. CP may be the first expression of pelvic endometriosis and TES can occurred in women without known pelvic endometriosis (PE) [18].…”

Endometriosis Toraks di Diafragma Dextra dengan Manifestasi Nyeri Dada dan Pneumotoraks

“…Beberapa diagnosis klinis dari sindrom endometriosis toraks antara lain pneumotoraks katamenial, hemotoraks katamenial, hemoptisis katamenial, dan nodul paru. 1,2,7,8 Sekitar 35% pneumotoraks spontan primer pada wanita merupakan pneumotoraks katamenial. 2,7 Kata 'katamenial' mengacu pada karakteristik tampilan klinis yang waktu kemunculannya berhubungan dengan siklus menstruasi.…”

Special Issue on “Clinical Research of Spontaneous Pneumothorax”

“…This Special Issue in the Journal of Clinical Medicine (JCM) brings together a series of high-quality scientific contributions that try to weave a common thread that extends from the etiology to the treatment of SP [ 1 , 2 , 3 , 4 , 5 ]. The covered topics distinctly point out the issues related to PSP and SSP, although both diseases present some similar approaches in the diagnostic–therapeutic path.…”

“…SSP, as defined by the British Thoracic Society (BTS) guidelines [ 16 ], is a pneumothorax occurring in patients with underlying lung disease, or in patients over 50 years of age with a significant smoking history. Underlying lung diseases include chronic obstructive pulmonary disease, interstitial lung disease, lung infections (i.e., pneumocystis, COVID-19, tuberculosis), lung cancer, and endometriosis [ 3 , 5 ]. SSP is more common than PSP, representing, according to English SP epidemiological data, over 60% of pneumothoraces.…”