INCIDENTAL EARLY LUNG ADENOCARCINOMA AFTER SURGERY FOR CATAMENIAL PNEUMOTHORAX (original) (raw)
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Catamenial pneumothorax due to bilateral pulmonary endometriosis
Respiratory care, 2012
Pulmonary endometriosis is diagnosed when endometrial tissue is found within the respiratory system. Pneumothorax is the most common presentation of this disorder. A 19-year-old female presented with symptoms of right-sided pneumothorax. She had a twoyear history of menstrual-related chest pain and right-sided pneumothorax requiring multiple hospitalizations. Emergent chest tube insertion was performed. She subsequently underwent video-assisted thoracoscopy. Pathology showed pulmonary endometriosis. The diagnosis of pulmonary endometriosis is often difficult. When pneumothorax occurs temporally with menstrual cycles, catamenial pneumothorax should be suspected. Video-assisted thoracoscopy is a safer and less invasive modality of therapy. (Tzu Chi Med J 2006; 18:305-307)
Catamenial pneumothorax revealing diaphragmatic endometriosis: a case report and revue of literature
Pan African Medical Journal
Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in women. We aim to discuss the etiology, clinical course, and surgical treatment of a 42-year-old woman with CP. This patient had a right-sided spontaneous pneumothoraces occurred one week after menses. She had undergone video-assisted thoracoscopic surgery (VATS) because of a persistent air leak under chest tube. VATS revealed multiple diaphragmatic fenestrations with an upper right nodule. Defects were removed and a large part of the diaphragm was resected. Pleural abrasion was then performed over the diaphragm. Diaphragmatic endometriosis was confirmed by microscopic examination. Medical treatment with GnRH agonists was prescribed, and after recovery, the patient has been symptoms free for 20 months.
Pneumothorax Associated with Thoracic Endometriosis: Current Knowledge
BJSTR, 2021
Endometriosis is a condition in which endometrial-like glands and stroma are located outside of the uterine cavity. The ectopic endometrium is encountered most commonly pelvic structures such as ovary, uterine ligaments, pelvic peritoneum, and genital structures [1-4]. The usual site of endometriosis outside of the abdominopelvic cavity is in or around the lung (intrathoracic cavity) (Figure 1). Although endometriosis in general can affect up to 15% of women of reproductive age,
American Journal of Respiratory and Critical Care Medicine, 2007
Rationale: Catamenial and endometriosis-related pneumothorax are considered relatively rare entities. Their clinical characteristics and outcome are incompletely known. Objectives: To evaluate the frequencies, clinical characteristics, and outcomes of catamenial and endometriosis-related pneumothoraces occurring in women with no underlying lung disease referred for surgical treatment. Methods: Clinical files of all the women of reproductive age referred to our center during a 6-year period for surgical treatment of spontaneous pneumothorax were retrospectively reviewed. Catamenial pneumothorax (CP) was defined as recurrent pneumothorax occurring between the day before and within 72 hours after the onset of menses. All histologic slides were reviewed to confirm initial diagnoses. Measurements and Main Results: A total of 114 women underwent video-assisted thoracic surgery; 28 women (24.6%) had CP (rightsided in all but one), and diaphragmatic abnormalities (perforations and/or nodules) were observed in 22 of them. Diaphragmatic abnormalities were seen in 21 of 86 patients with non-CP. Histologic examination found endometriosis, mainly diaphragmatic, in 18 of 28 CPs and 11 of 86 non-CPs. A 6-month antigonadotropic treatment was prescribed postoperatively to women with either CP or endometriosis-related pneumothorax. Mean follow-up was 32.7 (618.5) months. Recurrence rates in CP, non-CP but endometriosis-related, and non-CP non-endometriosis-related pneumothoraces were 32, 27, and 5.3%, respectively. Conclusions: Our experience shows that (1) CP and/or endometriosisrelated pneumothoraces account for an important percentage of spontaneous pneumothoraces referred for surgery, (2) diaphragmatic abnormalities seem to play a fundamental role in their pathogenesis, and (3) management is difficult because of the high recurrence rate.
Pneumoperitoneum associated with catamenial pneumothorax in women with thoracic endometriosis
Fertility and Sterility, 2009
Objective: To elucidate the pathophysiology of catamenial pneumothorax (CP) due to thoracic endometriosis and support the theory of the transdiaphragmatic passage of air from the genital tract through diaphragmatic perforations caused by endometrial implants. Design: Three case reports. Setting: Academic hospital. Patient(s): Three women with pneumoperitoneum concomitant to CP. Intervention(s): Thoracic/abdominal computed tomography scans and chest x-rays. Main Outcome Measure(s): Presence of pneumoperitoneum coexisting with CP. Result(s): The observation of pneumoperitoneum associated with CP supports the theory of the transdiaphragmatic passage of air, which implies the occurrence of a pneumoperitoneum as an intermediate step. Conclusion(s): Our three cases strongly support the theory of the transdiaphragmatic passage of air in the pathogenesis of CP. (Fertil Steril Ò 2009;91:930.e19-e22. Ó2009 by American Society for Reproductive Medicine.
Catamenial Pneumothorax: Presentation of an Uncommon Pathology: Review of Topic
2017
The catamenial pneumothorax is defined as the accumulation of air in the pleural cavity that appears in women infrequently and spontaneously with various clinical presentations. Actually, it is considered as an extremely rare entity with few cases described in the literature, that is the reason why the etiology is still discussed. However, a strong association with thoracic endometriosis syndrome has been found. We want to emphasize how the importance of conducting a diagnosis and having a timely management would improve the quality of life of the patient and give a better prognosis of the disease. Thus, a case report of a 38-year-old female patient who was receiving hormone therapy as a treatment for abdominal endometriosis and repetitive pneumothorax was presented. In the videoassisted thoracoscopy we saw diaphragmatic lesions and pneumothorax during the perioperative and postoperative period. Emphasize the importance of a detailed inspection of each intrathoracic organ during the...
A Case Report of Recurrent Spontaneous Pneumothorax Secondary to Thoracic Endometriosis Syndrome
American Journal of Medical Case Reports, 2021
Endometriosis is a benign condition in which ectopic endometrial glands and stroma are present outside of the uterine cavity. It commonly affects the pelvic organs but can also spread throughout the entirety of the body, including the thoracic cavity. The ectopic presence of endometrial glands and stroma in lung or pleura can produce a range of clinical and radiological manifestations-catamenial pneumothorax, catemenial hemothorax, catamenial hemoptysis, and pulmonary nodules-collectively referred to as "thoracic endometrial syndrome." Thoracic endometriosis constitutes an uncommon cause of spontaneous pneumothorax in nonsmoking women of childbearing age. Symptoms are often non-specific and the diagnosis is often delayed. A thorough menstrual history and its temporal relationship to pneumothorax onset should be assessed in every women presenting with recurrent pneumothorax. Thoracic endometriosis syndrome is very manageable with the advancements of VATS and hormonal therapy, but we as clinicians should have this on our differential diagnosis when a young, reproductiveaged female presents with a spontaneous pneumothorax to expedite appropriate care. Here we present a case of a 44 year old female with recurrent spontaneous pneumothorax that was attributed to thoracic endometriosis that will hopefully educate providers to have a high clinical suspicion in patients to obtain an accurate diagnosis and initiate proper treatment.
Catamenial pneumothorax: Presentation of an uncommon Pathology
Archives of Case Reports, 2017
The catamenial pneumothorax is defi ned as the accumulation of air in the pleural cavity that appears in women infrequently and spontaneously with various clinical presentations. Actually, it is considered as an extremely rare entity with few cases described in the literature, that is the reason why the etiology is still discussed. However, a strong association with thoracic endometriosis syndrome has been found. We want to emphasize how the importance of conducting a diagnosis and having a timely management would improve the quality of life of the patient and give a better prognosis of the disease. Thus, a case report of a 38-year-old female patient who was receiving hormone therapy as a treatment for abdominal endometriosis and repetitive pneumothorax was presented. In the video-assisted thoracoscopy we saw diaphragmatic lesions and pneumothorax during the perioperative and postoperative period. Emphasize the importance of a detailed inspection of each intrathoracic organ during the surgical procedure, we also showed how the intraoperative pleurodesis, the placement of a mesh on the diaphragm and the continuity of the hormonal treatment, seems to be an effective therapy to prevent recurrences and have a better control of the disease.
Catamenial pneumothorax due to solitary localization of diaphragmatic endometriosis
International Journal of Surgery Case Reports, 2015
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 72 h 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.