Case Report Abstract from the Archives of Nihon Kokyuki Gakkai Zasshi
Case Report Abstract from the Archives of Nihon Kokyuki Gakkai
Recurrence of Catamenial Pneumothorax After Surgical Treatment
Nihon Kokyuki Gakkai Zasshi 2000 Apr;38(4):278-282 (ISSN:
By: Shibata K; Aizawa H; Inoue H; Sugio K; Hara N
Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu
Authors report a case of catamenial pneumothorax that was
recurrent after surgical treatment.
A 43-year-old woman had sudden chest pain and dyspnea during
menstruation. Right pneumothorax and pleural effusion were pointed out on chest
X-ray films. When the patient was 31 years old, she received a diagnosis of
catamenial pneumothorax and underwent thoracotomy for resection of diaphragmatic
endometriosis. However, after surgery she experienced recurrence of right
pneumothorax, and was accordingly treated with danocrine. The patient decided to
terminate medication by herself because her symptoms had disappeared.
Several years after the cessation of medication, she experienced chest pain
frequently during menstruation, but did not seek a medical check-up. She visited
author's department because of persistent chest pain in 1997. After the patient
was hospitalized, pneumothorax was diagnosed and continuous drainage was
performed. Although pneumothorax was alleviated by drainage, it recurred during
the patient's next menstrual period. Open lung surgery was performed.
Diaphragmatic endometriosis with a small hole and inflammatory thickened lesions
on the visceral pleura of the lower lobe (S 6) were found and excised.
Microscopic examination of the excised specimens showed endometriosis. Visceral
pleural endometriosis has been histologically demonstrated in very few cases.
After surgery, hormonal therapy was started.
The patient has been well for 12 months without recurrence of pneumothorax. Both
surgical and hormonal treatment were considered necessary for the treatment of
catamenial pneumothorax in this case.