Catamenial pneumothorax with umbilical and diaphragmatic endometriosis: A case report and review of the literature

A 44-year-old female presented with a history of recurrent right-sided pneumothoraces, uterine fibroids, and a palpable lump in her navel. Total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) and resection of the umbilical nodule was performed. Intraoperative inspection of the right hemidiaphragm revealed adherent brownish-blue nodules without any associated diaphragmatic defects and a similar-appearing nodule at the umbilicus. She had no symptoms of pelvic endometriosis, nor did surgical exploration reveal any. Her postoperative course was uneventful and she denied recurrent pneumothorax at 12-month followup. Recurrent pneumothoraces in women of a reproductive age should raise the suspicion of thoracic endometriosis. Failure to establish the diagnosis prevents appropriate curative interventions.