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Catamenial pneumothorax due to heterotopic endometriosis in the pericardium
  1. Yuki Takigawa1,
  2. Daisuke Mizuno2,
  3. Norichika Iga2 and
  4. Nobukazu Fujimoto3
  1. 1Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan
  2. 2Department of Surgery, Okayama Rosai Hospital, Okayama, Japan
  3. 3Department of Medical Oncology, Okayama Rosai Hospital, Okayama, Japan
  1. Correspondence to Dr Nobukazu Fujimoto; nobufujimot{at}


A 46-year-old woman presented with a right pneumothorax at a regular medical examination during menstruation. The pneumothorax resolved without intervention; however, 6 months later, she was referred to our hospital due to chest pain and dyspnoea. A chest X-ray showed grade III pneumothorax and surgery was performed. During surgery, the patient was found to have pleural adhesions around the right upper lung, pores in the diaphragm and a blueberry spot in the pericardium. The margins of the upper lobe and diaphragm were covered with a polyglycolic acid sheet at the operation. Eight days after surgery, she was referred to our hospital again due to massive haemothorax. The reoperation suggested that the aforementioned blueberry spot in the pericardium was the source of bleeding. The spot was resected and shown to be oestrogen and progesterone receptor-positive, providing evidence of heterotopic endometriosis.

  • pneumomediastinum
  • pneumothorax

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  • Contributors YT, DM and NI contributed by conception and design, acquisition of data or analysis, interpretation of data and drafting the article. YT and NF contributed by drafting the article and gave a final approval of the version published.

  • Funding This study was funded by Ministry of Health, Labor, and Welfare, Japan (180101-02).

  • Competing interests NF reports grants from KISSEI and MSD, grants and personal fees from ONO, Bristol-Meyers Squib, Kyorin, personal fees from Chugai and personal fees from Daiichi Sankyo.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.