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Catamenial pneumothorax due to solitary localization of diaphragmatic endometriosis.
Int J Surg Case Rep 2015; 12:19-22IJ

Abstract

INTRODUCTION

Catamenial pneumothorax (CP) is a spontaneous recurrent pneumothorax occurring in women in reproductive age. The etiology of CP has been associated with thoracic endometriosis and is its most common presentation.

PRESENTATION OF CASE

A case of right catamenial pneumothorax in a 38 year old woman is presented in which three episodes of CP occurred within 72h of menses in a 6 month period. The patient underwent videothoracoscopy that revealed a solitary localization of diaphragmatic endometriosis. After surgical pleurodesis and based on final pathology of resected lesion, hormonal treatment was started. The outcome was uneventful and the patients is symptom-free at 6 months.

DISCUSSION

Catamenial pneumothorax (CP) is a rare clinical entity characterized by lung collapse during menstruation, believed to be secondary to pleural endometriosis. Nearly all catamenial pneumothorax occur on the right side as pleural lesions are almost exclusively right-sided. Diagnostic imaging is based on high resolution computed tomography (HRCT) and, preferably, magnetic resonance imaging (MRI) since it is able to detect the blood products in the endometrial deposits. However the lack of macroscopic findings at surgery makes this condition still under-diagnosed. Based on the solitary diaphragmatic localization of endometriosis in our case we preferred to limit surgery to videothoracoscopic pleurodesis and start hormonal treatment with successful outcome.

CONCLUSION

Catamenial pneumothorax is the most common presentation of thoracic endometriosis syndrome and should always be suspected in women in childbearing age. Treatment option are still debated but best results are achieved by videothoracoscopic pleurodesis combined with hormonal therapy.

Authors+Show Affiliations

Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Italy. Electronic address: elia@med.uniroma2.it.Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Italy.Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Italy.Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25981153

Citation

Elia, Stefano, et al. "Catamenial Pneumothorax Due to Solitary Localization of Diaphragmatic Endometriosis." International Journal of Surgery Case Reports, vol. 12, 2015, pp. 19-22.
Elia S, De Felice L, Varvaras D, et al. Catamenial pneumothorax due to solitary localization of diaphragmatic endometriosis. Int J Surg Case Rep. 2015;12:19-22.
Elia, S., De Felice, L., Varvaras, D., Sorrenti, G., Mauriello, A., & Petrella, G. (2015). Catamenial pneumothorax due to solitary localization of diaphragmatic endometriosis. International Journal of Surgery Case Reports, 12, pp. 19-22. doi:10.1016/j.ijscr.2015.05.012.
Elia S, et al. Catamenial Pneumothorax Due to Solitary Localization of Diaphragmatic Endometriosis. Int J Surg Case Rep. 2015;12:19-22. PubMed PMID: 25981153.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Catamenial pneumothorax due to solitary localization of diaphragmatic endometriosis. AU - Elia,Stefano, AU - De Felice,Laura, AU - Varvaras,Dimitrios, AU - Sorrenti,Giuseppe, AU - Mauriello,Alessandro, AU - Petrella,Giuseppe, Y1 - 2015/05/07/ PY - 2015/04/01/received PY - 2015/04/27/revised PY - 2015/05/04/accepted PY - 2015/5/19/entrez PY - 2015/5/20/pubmed PY - 2015/5/20/medline KW - Catamenial KW - Endometriosis KW - Hormonal treatment KW - Pleurodesis KW - Pneumothorax KW - Thoracoscopy SP - 19 EP - 22 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 12 N2 - INTRODUCTION: Catamenial pneumothorax (CP) is a spontaneous recurrent pneumothorax occurring in women in reproductive age. The etiology of CP has been associated with thoracic endometriosis and is its most common presentation. PRESENTATION OF CASE: A case of right catamenial pneumothorax in a 38 year old woman is presented in which three episodes of CP occurred within 72h of menses in a 6 month period. The patient underwent videothoracoscopy that revealed a solitary localization of diaphragmatic endometriosis. After surgical pleurodesis and based on final pathology of resected lesion, hormonal treatment was started. The outcome was uneventful and the patients is symptom-free at 6 months. DISCUSSION: Catamenial pneumothorax (CP) is a rare clinical entity characterized by lung collapse during menstruation, believed to be secondary to pleural endometriosis. Nearly all catamenial pneumothorax occur on the right side as pleural lesions are almost exclusively right-sided. Diagnostic imaging is based on high resolution computed tomography (HRCT) and, preferably, magnetic resonance imaging (MRI) since it is able to detect the blood products in the endometrial deposits. However the lack of macroscopic findings at surgery makes this condition still under-diagnosed. Based on the solitary diaphragmatic localization of endometriosis in our case we preferred to limit surgery to videothoracoscopic pleurodesis and start hormonal treatment with successful outcome. CONCLUSION: Catamenial pneumothorax is the most common presentation of thoracic endometriosis syndrome and should always be suspected in women in childbearing age. Treatment option are still debated but best results are achieved by videothoracoscopic pleurodesis combined with hormonal therapy. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/25981153/Catamenial_pneumothorax_due_to_solitary_localization_of_diaphragmatic_endometriosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(15)00232-1 DB - PRIME DP - Unbound Medicine ER -