[Catamenial pneumothorax--endometriosis as a multidisciplinary challenge]

While the occurrence of heterotopic endometrial tissue is relatively common during the reproductive years, involvement of the pulmonary pleura is an extremely rare event. Since the condition is poorly understood, patients with "catamenial pneumothorax" tend to be subjected to often quite stressful surgical procedures. These do not provide a permanent cure, as shown by the presented case. Traditional hormonal regimens are also associated with high relapse rates. Consequently, abdominal hysterectomy with bilateral removal of the adnexa has been the treatment of choice if fertility was no longer desired. The battery of conservative treatment modalities has, however, recently been expanded by the use of GnRH analogues and antigestagens. As embryogenesis and the factors underlying the development of endometriosis are better understood and as the complex symptoms of the condition as well as the state-of-the-art therapeutic approaches are more widely appreciated, women afflicted with the condition should be able to benefit from a more rational and possibly even causal treatment concept.