A Case of Catamenial Pneumothorax During Pregnancy

• Published in: The Journal of the Japan Society for Respiratory Endoscopy Vol. 41; no. 4; pp. 370 - 374
• Main Authors: Sonokawa, Takumi, Matsui, Takuma, Takegahara, Kyoshiro, Inoue, Tatsuya, Usuda, Jitsuo
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society for Respiratory Endoscopy 25.07.2019
• Subjects: Catamenial pneumothorax; Thoracic endometriosis syndrome; Video-assisted thoracoscopic surgery
• ISSN: 0287-2137; 2186-0149
• DOI: 10.18907/jjsre.41.4_370

Background. Catamenial pneumothorax occurs before and after menstruation and has been characterized as not occurring during periods of amenorrhea, such as during pregnancy. However, there remains no clear understanding of the mechanism of its occurrence. Here, we report a case of catamenial pneumothorax that occurred during pregnancy. Case. A 32-year-old woman had been aware of chest pain at the time of menstruation since the age of 29 years and was suspected of having catamenial pneumothorax. However, her symptoms were relieved with conservative treatment. At 34 weeks and 4 days of gestation, she experienced chest pain and we diagnosed right pneumothorax. After giving birth by cesarean section, air leak continued and thoracoscopic surgery was performed. Intraoperative observation showed a 1-cm, large cystic lesion in the right middle lobe, as well as several small pores in the diaphragm. Therefore, we performed partial resection of the right middle lobe, as well as biopsy of diaphragmatic lesion and subsequent repair. Pathological examination showed estrogen receptor and progesterone receptor-positive cells around the cyst wall and diaphragm pores. Therefore, the patient was given a diagnosis of catamenial pneumothorax. Conclusion. In this case, pneumothorax occurred during pregnancy. Thus, this may be a valuable case for consideration of the mechanism of catamenial pneumothorax.