# Catamenial Pneumothorax Without Thoracic Endometriosis: A Case Report From the Gulf Cooperation Council (GCC) Region

## TL;DR

A rare case of catamenial pneumothorax in a 37-year-old woman without thoracic endometriosis is reported from the GCC region.

## Contribution

This case highlights catamenial pneumothorax occurring without thoracic endometriosis, a rare phenomenon in clinical practice.

## Key findings

- The patient had recurrent pneumothorax linked to her menstrual cycle but no thoracic endometriosis was found.
- Pelvic endometriosis was identified during laparoscopy, suggesting a possible pelvic origin of the condition.
- Hormonal therapy was effective in managing the patient's symptoms.

## Abstract

Catamenial pneumothorax is a rare clinical condition first described over seven decades ago. It typically occurs within 72 hours before or after menstruation and is most frequently observed in women of reproductive age. Reports from the Gulf Cooperation Council (GCC) region, including Qatar, remain limited, and underreporting has also been noted in developed countries such as Australia. This report presents a case of catamenial pneumothorax without evidence of thoracic abnormal endometriosis. A 37-year-old woman presented repeatedly to the emergency department with chest pain occurring during menstruation. Chest radiography showed a right-sided pneumothorax. Video-assisted thoracoscopy revealed right upper lobe blebs, which were excised. Laparoscopy identified the spread of endometrial tissue in the pelvis, ovaries, and uterus. The patient was treated with hormonal oral contraceptive therapy and remains under outpatient follow-up. Catamenial pneumothorax can occur in the absence of endometrial thoracic tissue. A high index of suspicion is essential for diagnosis in reproductive-aged women with recurrent spontaneous pneumothorax.