We report 3 cases of
catamenial pneumothorax, with review of the literatures. Case 1: A 38-year-old female had recurrent right-sided
pneumothorax in February 2001. Videothoracoscopic visualization showed multiple small fenestrations in central tendon of diaphragm. A partial diaphragmatic resection including the lesions was performed. She received
hormone therapy postoperatively. Case 2: A 40-year-old female with past history of ovarian
endometriosis had recurrent right-sided
pneumothorax in 1993. During the operation, multiple diaphragmatic fenestrations and
bullae of right middle and lower lobes were identified. The lesions were resected and postoperative
hormone therapy was performed for 6 months. In 1997, right-sided
pneumothorax recurred. She underwent
surgical procedure due to prolonged air leakage from the right lung. During the operation, a diaphragmatic fenestration and
bulla of apex of right upper lobe of the lung were visualized. Diaphragm was reefed and
bulla was resected. After that, she had no recurrence of
pneumothorax. Case 3: A 39-year-old female had recurrent right-sided
pneumothorax in 2003. Under video-assisted thoracoscopic surgery, multiple fenestrations of central tendinous diaphragm were identified. Diaphragmatic partial resection was performed. Postoperatively, she received
hormone therapy for 6 months. After
hormone therapy, she suffered from recurrent
pneumothorax, and underwent an operation. During the operation, she had
endometriosis of visceral pleura without diaphragmatic fenestration. Once again, she received postoperative
hormone therapy.
Catamenial pneumothorax is a
rare disease, and the definite etiology has not been clarified. A combination of both surgical and
hormone therapy is useful for treatment.