01 July 2025
: Case report 
Balancing Catamenial Pneumothorax Management with Fertility: Insights from GnRH Agonist Use
Unusual clinical course, Unusual or unexpected effect of treatment, Rare disease
Eka Maranatha Tambunan
ABE 1*, Dina Marlina BEF 1, Aditya Utomo ABDE 1, Putri Nadhira Adinda Adriansyah AEF 2, Edy Priyanto ABCDFG 3, Muhammad Alamsyah Aziz ABCD 1, Dody Novrial BDF 4
DOI: 10.12659/AJCR.947589
Am J Case Rep 2025; 26:e947589
Table 1 Summary of selected case reports and series on catamenial pneumothorax.
| Author (year) | No. of CP patients | Symptoms | Side involved | Diaphragmatic lesions | Visceral pleural involvement | Histological endometriosis | Hormonal therapy | Recurrence |
|---|---|---|---|---|---|---|---|---|
| Joseph and Sahn (1996) []18 | 28 | Chest pain, dyspnea, recurrence around menses | Mostly right | ~40% with diaphragm defects | ~30% pleural involvement | 31% confirmed | Various regimens | Not detailed |
| Marshall et al (2005) []16 | 8 | Chest pain, dyspnea, cyclic symptoms with menses | 100% right | 5 with diaphragmatic implants, 4 with holes | 2 with pleural implants | Confirmed in some cases | GnRH agonist more effective than OCP | 37.5% |
| Alifano et al (2007) []8 | 5 | Chest pain, dyspnea, recurrence with menses | 27 right/ 1 left | 22 with fenestrations or nodules | 11 with visceral pleural nodules (14%) | 64% confirmed | GnRH agonist (6 months) post-op | 32% |
| Visouli et al (2012) []17 | 110 (80 CP) | Dyspnea, pleuritic pain, menses-associated CP | 100% right | Multiple fenestrations and nodules | 1 lung bleb with hemosiderin | Suggestive, not confirmed | GnRH agonist (1 case); others unclear | Not reported |
| Legras et al (2014) []21 | 229 (80 CP) | Dyspnea, pleuritic pain, menses-associated CP | 63% right | 43/54 (80%) with diaphragmatic lesions | 15% with visceral pleura involvement | Stroma in 92.5%, glands in 62.5%, CD10+ | 34% received pre-operation hormonal therapy | Not detailed |
| Present Case (2024) | 1 | Shortness of breath worsening with menstruation | Right-sided | Superficial brown lesions on diaphragm | Bullae resected; pulmonary atelectasis | Confirmed (CD10+, ER+, PR+) | Single GnRH agonist 7 yrs prior to CP; no suppression post-op (for fertility) | None |