title: Surgical treatment of catamenial pneumothorax: Report of three cases.
abstract: Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in females. Although it has been known to be associated with thoracic endometriosis, varying clinical course and the lack of consistent intraoperative findings have led to conflicting etiological theories. We herein discuss the etiology, clinical course, and surgical treatment of three patients with CP. Three females (aged 40 years, 28 years, and 34 years) had recurrent right-sided spontaneous pneumothoraces that coincided with their menses. They had undergone video-assisted thoracoscopic surgery (VATS) previously. Blueberry spots in the right diaphragm were detected in all three cases. Two patients had recurrence, postoperatively. The other patient, who received luteinizing hormone-releasing hormone analog therapy for an abdominal endometriosis in the perioperative period and postoperative chemical pleurodesis to prevent recurrence, has been free of recurrence for 15 months, postoperatively. However, pelvic endometriosis was detected in this patient only. Therefore, CP should be suspected in ovulating females with spontaneous pneumothorax, even in the absence of any symptoms associated with pelvic endometriosis. In addition, while performing VATS, careful inspection of the diaphragmatic surface is important. In complicated cases, hormonal suppression therapy and chemical pleurodesis might also be helpful adjunct modalities.
authors.affiliation: Department of Chest Surgery and Pathology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan. Electronic address: y-ichiki@med.uoeh-u.ac.jp.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Ichiki
authors.affiliation: Department of Chest Surgery and Pathology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Nagashima
authors.affiliation: Department of Chest Surgery and Pathology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Yasuda
authors.affiliation: Department of Chest Surgery and Pathology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takenoyama
authors.affiliation: Department of Chest Surgery and Pathology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Toyoshima
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008598:Menstruation; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D020775:Thoracic Surgery, Video-Assisted
keywords: catamenial pneumothorax; pneumothorax; surgical treatment