Operative and hormonal management of recurrent catamenial pneumothorax: a case report

Abstract

Catamenial pneumothorax refers to the recurrent collapse of a lung in conjunction with the menstrual cycle. It is a common manifestation of thoracic endometriosis syndrome, a rare condition involving extra-pelvic endometrial lesions. We describe a case of catamenial pneumothorax that has not recurred after treatment with hysterectomy and bilateral salpingo-oophorectomy. A 37-year-old woman with abdominal endometriosis presented with five episodes of right pneumothorax, all of which coincided with the patient’s menstrual cycle. The diagnosis of catamenial pneumothorax was made, and the patient was referred for hysterectomy and bilateral salpingo-oophorectomy. Combined transdermal estrogen/progesterone treatment was also initiated to manage her symptoms of hot flashes, vaginal dryness, and dyspareunia. Since treatment, the patient has not had recurrent pneumothorax. Due to the rarity and acuity of catamenial pneumothoraces, management options are challenging. Recommendations on the duration of combined estrogen/progesterone treatment following bilateral oophorectomy are needed. A multidisciplinary team approach consisting of pulmonologists, thoracic surgeons, and gynecologists is essential for accurate diagnosis, optimal treatment, and successful outcomes in this rare but serious condition.

Catamenial pneumothorax – are there benefits of cooperation between the surgeon and the gynaecologist?

“…There are also studies suggesting that such therapy should be used only in selected cases. Other types of hormonal treatment, less widely used in CP treatment, include hormone contraceptives, GnRH agonist plus progesterone, progesterone, and danazol [ 11 , 12 ]. There are some reports proving the effectiveness of hysterectomy with bilateral salpingo-oophorectomy as a definitive treatment of CP [ 13 ].…”