A 39 years old woman with thoracic endometriosis presents with recurrent catamenial Pneumothorax: A case report

Introduction and importance

Recurrent catamenial pneumothorax (RCP) is an infrequent medical condition predominantly affecting women of reproductive age. It is characterized by the repeated occurrence of pneumothorax, resulting in either partial or complete lung collapse due to air or gas in the pleural cavity. The distinctive feature of this condition is its association with the menstrual cycle, with symptoms typically manifesting within 72 h following the onset of menstruation. While catamenial pneumothorax is recognized as the most prevalent form of thoracic endometriosis syndrome, recurrent catamenial pneumothorax remains uncommon and lacks comprehensive characterization in the medical literature. Consequently, the understanding of this condition's underlying mechanisms and contributing factors is limited.

Case presentation

The present report describes a thirty-nine-year-old woman with recurrent pneumothorax. Video-assisted thoracoscopic surgery (VATS) with pleurodesis reveals diffuse parietal pleura and diaphragm inflammation. Notably, red nodules and pores were observed in the central region of the right hemidiaphragm, providing compelling evidence supporting thoracic endometriosis and catamenial pneumothorax as the underlying cause. A pneumonolysis, wedge resection, partial pleurectomy, and pleural abrasion were performed, followed by applying a mesh graft to the diaphragm. After surgery, the patient was referred for hormonal therapy and remained symptom-free during follow-up visits.

Clinical discussion

This case highlights the importance of recognizing catamenial pneumothorax. For treatment, both surgical intervention and hormonal therapy are essential.

Conclusion

RCP should be considered as one of the differential diagnoses in reproductive-aged women presenting with repeated spontaneous pneumothorax, particularly during menstrual periods.