Abstract
A 45-year-old nonsmoking woman with repeated coughing and dyspnea on effort was admitted to our hospital diagnosed with right-sided pneumothorax on chest X-ray. Chest computed tomography showed neither bullae nor nodules. Chest drainage failed to completely reexpand the lung, necessitating video-assisted thoracic surgery. Thoracoscopy showed pleural thickening in the apical segment without bullae or air leakage, dark-brown pigmentation of the diaphragm, and an unsuspected small nodule about 5 mm in diameter on the diaphragmatic surface of the right lower lobe. Pneumothorax was treated by mechanical abrasion of parietal pleura and upper lobe wedge resection. The lower lobe and nodule were wedge-resected using staplers. The nodule was bronchioloalveolar carcinoma of Noguchi’s type B. To improve curability and check for diaphragmatic lesions, right posterolateral thoracotomy was conducted on post-video-assisted thoracic surgery day 28. Aggressive intraoperative lymph node exploration yielded no remarkable histological findings. Nonanatomical lower lobe wedge resection was done and the diaphragm with pinhole-like perforations was partially resected. The resected lung showed no cancerous tissue. Endometrial tissue was histologically confirmed in the resected diaphragm. The patient has remained asymptomatic in 14-month follow-up. This is, to our knowledge, the first lung cancer accompanied by catamenial pneumothorax.
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Steinhäuslin CA, Cuttat JF. Spontaneous pneumothorax. A complication of lung cancer? Chest 1985; 88: 709–13.
Noguchi M, Morikawa A, Kawasaki M, Matsuno Y, Yamada T, Hirohashi S, et al. Small adenocarcinoma of the lung. Cancer 1995; 75: 2844–52.
Van-Schil PE, Vercauteren SR, Vermeire PA, Nackaerts YH, Van-Marck EA. Catamenial pneumothorax caused by thoracic endometriosis. Ann Thorac Surg 1996; 62: 585–6.
Blanco S, Hernando F, Gómez A, González MJ, Torres AJ, Balibrea JL. Catamenial pneumothorax caused by diaphragmatic endometriosis. J Thorac Cardiovasc Surg 1998; 116: 179–80.
Yamashita J, Iwasaki A, Kawahara K, Shirakusa T. Thoracoscopic approach to the diagnosis and treatment of diaphragmatic disorders. Surg Laparosc Endosc 1996; 6: 485–8.
Yoshioka H, Takeuchi T, Matsuno Y, Yamada T, Shimosato Y, Hirohashi S, et al. Analysis of loss of heterozygosity in small adenocarcinomas of the lung. Jpn J Clin Oncol 1998; 28: 240–4.
Lung Cancer Study Group (prepared by Ginsberg RJ and Rubinstein LV). Randomized trial of lobectomy versus limited resection for T1 N0 non-small-cell lung cancer. Ann Thorac Surg 1995; 60: 615–23.
Landreneau RJ, Sugarbaker DJ, Mack MJ, Hazelrigg SR, Luketich JD, Fetterman L, et al. Wedge resection versus lobectomy for stage I (T1 N0 M0) non-small-cell lung cancer. J Thorac Cardiovasc Surg 1997; 113: 691–700.
Tsubota N, Ayabe K, Doi O, Mori T, Namikawa S, Taki Y, et al. Ongoing prospective study of segmentectomy for small lung tumors. Ann Thorac Surg 1998; 66: 1787–90.
Takizawa T, Terashima M, Koike T, Watanabe T, Kurita Y, Yokoyama A, et al. Lymph node metastasis in small peripheral adenocarcinoma of the lung. J Thorac Cardiovasc Surg 1998; 116: 276–80.
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Iwasaki, T., Matsumura, A., Yamamoto, S. et al. Unsuspected lung cancer accompanied by catamenial pneumothorax. Jpn J Thorac Caridovasc Surg 48, 676–679 (2000). https://doi.org/10.1007/BF03218229
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DOI: https://doi.org/10.1007/BF03218229