Neumotórax catamenial secundario a endometriosis torácica

We report the case of a 27-year-old tertipara, with one caesarean, with menarche at the age of 13 years, regular cycles, disabling dysmenorrhea twice a year, and one sexual partner, who reported mild dyspareunia and was referred to our hospital, which serves a rural population in Jalisco (Mexico). The patient showed poor general health status, with severe dyspnea, and reported that she had experienced the same symptoms twice before in the previous 4 months. The patient showed a pneumothorax size of 40%. A closed chest drainage system was placed, producing substantial improvement in the 3 subsequent days with respect to admission. Pulmonary tomography 3 days later showed no abnormalities. CA125 determination revealed 102 U/ml and pelvic ultrasound showed a positive anechoic, 4×5-cm image in the left annex. Pelvic laparotomy was performed, revealing mild endometriosis with lesions in the posterior uterine wall and no diaphragmatic lesions. Thoracoscopy showed two endometriotic foci of approximately 1×1 cm, and another of 1×0.5 cm. The histological diagnosis was endometrial tissue in the lung parenchyma.