子宮内膜症治療中に発症した月経随伴性気胸

Catamenial Pneumothorax During Endometriosis Treatment

月経随伴性気胸は月経開始24時間前から開始後72時間以内に発症する気胸と定義されているが，月経周期と無関係に発症する症例も報告されている1，2）．われわれは子宮内膜症に対する黄体ホルモン療法で無月経状態であったにもかかわらず，月経随伴性気胸を発症した症例を経験したため報告する．

Here, we report a case of catamenial pneumothorax that occurred during endometriosis treatment. A 46-year-old woman presented with a history of right pneumothorax. At 43 years of age, the patient was diagnosed with endometriosis and progesterone therapy was initiated. The patient developed right-sided chest pain and was diagnosed with right-sided pneumothorax. Video-assisted thoracoscopic surgery was performed, because of persistent air leakage. Intraoperative findings revealed a suspected pleural defect in the right upper lobe and multiple perforations around the central tendon of the right diaphragm. The pleural defect was resected, and the diaphragm surface was covered with a polyglycolic acid sheet. Pathologically, the diagnosis was associated with thoracic endometriotic pneumothorax, including immunostaining findings. Hormonal therapy was continued after discharge. The patient has remained free of recurrence for one year postoperatively.