A Very Rare Entity: Catamenial Pneumothorax

Abstract

Catamenial pneumothorax, a variant of spontaneous pneumothorax occurs exclusively in women of menstrual age. Catamenial pneumothorax is associated with a high rate of recurrence. The etiology and pathogenesis is enigmatic. We describe the case of a 42-year-old woman with right-sided catamenial pneumothorax recurring four times, caused by ectopic endometriosis in the pleural layers which was confirmed histopathologically. Surgical treatment should be accomplished during menstruation for optimal visualization of pleurodiaphragmatic endometriosis.

Value of cancer antigen 125 for diagnosis of pleural endometriosis in females with recurrent pneumothorax

“…Cases of CP are currently published as case reports considered as very rare entities [13]. CP represents 29% (nine out of 31) of spontaneous pneumothorax in females.…”

Unusual Cause of Recurrent Chest Pain: Catamenial Pneumothorax

“…We are interested, in our observation, to CP. Endometriosis can affect up to 15% of women in their reproductive first year [1][2][3].…”

“…Typically, it occurs in women aged 30-40 years, but has been diagnosed in young girls as early as 10 years of age and post-menopausal women. Some sources claim this entity represents 3-6% of pneumothorax in women [1]. In regard of the low incidence of primary spontaneous pneumothorax (i.e.…”

Occurrence of Primary Umbilical Endometriosis and Recurrent Catamenial Pneumothorax

“…10 Some of the theories that exist to explain how catamenial pneumothorax occurs are (1) loss of the cervical mucous plug during the menstrual phase leading to air in the peritoneum, which then transverses through the diaphragm into the pleural space; (2) spontaneous rupture of blebs or bullae during hormonal changes; (3) elevated prostaglandins leading to bronchiolar vasospasm and constriction; and (4) metastatic spread of endometrial tissue. 8 Once catamenial pneumothorax is suspected, a video-assisted thoracic surgery to examine the lung parenchyma and diaphragm is the suggested approach. This procedure should be timed with the menstrual cycle, so as to increase the likelihood of visualization of any endometriotic implants present, and any lesions should be excised.…”

“…First described by Maurer et al in 1958, the menstrually related spontaneous pneumothorax was later named catamenial pneumothorax by Lillington in 1972. 8 Catamenial pneumothorax have been found to occur within 72 hours of the start of menses and are commonly recurrent. 9 Korom et al state that ''not all of a patient's menses coincide with a pneumothorax, but each episode of a catamenial pneumothorax is associated with the menstrual flow.''…”