Catamenial Pneumothorax-Still an Unveiled Disease

Area of Science:

• Thoracic Surgery
• Gynecology
• Pulmonology

Background:

• Catamenial pneumothorax (CP) is an uncommon condition often associated with thoracic endometriosis syndrome (TES).
• TES involves endometriotic lesions in the pleura and lung, leading to symptoms like CP, hemothorax, and hemoptysis.
• Diagnosis of CP is frequently delayed, and pulmonary endometriotic lesions may not always be present.

Purpose of the Study:

• To review current opinions on the pathophysiology, diagnosis, and management of catamenial pneumothorax.
• To highlight the importance of a multidisciplinary approach in diagnosing and treating CP.
• To discuss emerging therapeutic options for CP.

Main Methods:

• Literature review of current opinions and research on catamenial pneumothorax and thoracic endometriosis syndrome.
• Analysis of diagnostic methods including conventional radiography and computed tomography.
• Overview of current and potential therapeutic strategies.

Main Results:

• CP typically presents with pneumothorax symptoms coinciding with menstruation (around 24h before to 72h after onset), though not always cyclically.
• Radiographic findings may include pneumoperitoneum, lung opacities, pleural effusion, and nodular infiltrates.
• CT scans can further reveal pneumoperitoneum and diaphragmatic lesions.

Conclusions:

• Effective management of CP requires addressing acute symptoms and implementing causal treatment to prevent recurrence.
• A multidisciplinary approach is essential for optimal diagnosis and treatment selection.
• International guidelines for CP management are still lacking, despite promising new therapeutic options.