A case of pulmonary endometriosis presenting with catamenial pneumothorax.

Kim, Min Gyun; Kim, Chung Hoon; Lee, Sa Ra; Ju, Da Hye; Kim, Sung Hoon; Chae, Heedong; Kang, Byung Moon

Case Report

Korean Journal of Obstetrics & Gynecology 2007;50(11):1576-1580.
Published online November 1, 2007.

A case of pulmonary endometriosis presenting with catamenial pneumothorax.

Min Gyun Kim, Chung Hoon Kim, Sa Ra Lee, Da Hye Ju, Sung Hoon Kim, Heedong Chae, Byung Moon Kang

Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. chkim@amc.seoul.kr

Abstract

Endometriosis is a relatively common gynecologic disease. However thoracic endometriosis syndrome is exceedingly rare among various types of external endometriosis. We experienced a case of 35-year-old woman who presented with recurrent episodes of spontaneous right-sided pneumothorax that occurred during her menstrual periods. After the localization of the disease site by means of chest radiography and computed tomography of the thorax, a chest tube was inserted after which bullectomy and pleurodesis using doxycycline were performed. A hormonal treatment with gonadotropin-releasing hormone (GnRH) agonist for 12-months was also conducted. However, right-sided pneumothorax recurred two times after these procedures. Subsequently, surgical excision of diaphragmatic lesion along with pleurodesis was underwent. To prevent recurrence, we maintained long-term GnRH agonist administration with add back therapy using low dose estrogen-progesterone. Menstruation stopped, and the chest pain disappeared. During a 19-months follow-up period, pneumothorax did not recur. We report this case with a brief review of the concerned literatures.

Key Words: Catamenial pneumothorax, Endometriosis, GnRH agonist