Operative and hormonal management of recurrent catamenial pneumothorax: A case report

Sivaraman K Iyer BS, Jessica Clay Ehrig MD, Marcos Sosa MD, Jennifer Phy DO


Catamenial pneumothorax refers to the recurrent collapse of a lung in conjunction with the menstrual cycle. It is a common manifestation of thoracic endometriosis syndrome, a rare condition involving extra-pelvic endometrial lesions. We describe a case of catamenial pneumothorax that has not recurred after treatment with hysterectomy and bilateral salpingo-oophorectomy. A 37-year-old woman with abdominal endometriosis presented with five episodes of right pneumothorax, all of which coincided with the patient’s menstrual cycle. The diagnosis of catamenial pneumothorax was made, and the patient was referred for hysterectomy and bilateral salpingo-oophorectomy. Combined transdermal estrogen/progesterone treatment was also initiated to manage her symptoms of hot flashes, vaginal dryness, and dyspareunia. Since treatment, the patient has not had recurrent pneumothorax. Due to the rarity and acuity of catamenial pneumothoraces, management options are challenging. Recommendations on the duration of combined estrogen/progesterone treatment following bilateral oophorectomy are needed. A multidisciplinary team approach consisting of pulmonologists, thoracic surgeons, and gynecologists is essential for accurate diagnosis, optimal treatment, and successful outcomes in this rare but serious condition.

Keywords: Catamenial pneumothorax, endometriosis/therapy, thoracic diseases, menstrual cycle

Article citation: Iyer SK, Jessica Clay Ehrig JC, Marcos Sosa M, Phy J. Operative and hormonal management of recurrent catamenial pneumothorax: a case report. The Southwest Respiratory and Critical Care Chronicles 2018;6(26):1–4
From: Texas Tech University Health Sciences Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Lubbock, TX (SKI, JP); University of Colorado, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Aurora, CO (JCE); Little River Healthcare, Department of Women’s Health, Killeen, TX (MS)
Submitted: 4/7/2018
Accepted: 7/15/2018
Reviewers: Chok Limsuwat MD, Anoop Nambiar MD
Conflicts of interest: none
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