Abstract
Malignant pleural effusions are common in patients with cancer. Most malignant pleural
effusions are secondary to metastases to the pleura, most often from lung or breast
cancer. The presence of malignant effusion indicates advanced disease and poor survival;
in lung cancer, the presence of malignant effusion upstages the cancer to stage 4.
Usually presenting as a large, unilateral exudative effusion, most patients with malignant
pleural effusion experience dyspnea. Prior to intervention, diagnosis of malignant
pleural effusion and exclusion of infection should be made. Thoracic imaging is typically
performed, with computed tomography considered by many to be the gold standard. Thoracic
ultrasound is also useful, particularly if diaphragmatic or pleural thickening and
nodularity can be identified. Cytology should then be obtained; this is typically
done via pleural fluid aspiration or pleural biopsy. Treatment focuses on palliation
and relief of symptoms. Numerous interventions are available, ranging from drainage
with thoracentesis or indwelling pleural catheter to more definitive, invasive options
such as pleurodesis. There is no clear best approach, and a patient-centered approach
should be taken.
Keywords
Abbreviations:
ARDS (Acute respiratory distress syndrome), CT (Computed tomography), ECOG (Eastern Cooperative Oncology Group), IPC (Indwelling pleural catheter), LENT (pleural fluid lactate dehydrogenase level, ECOG score, serum neutrophil to lymphocyte ratio, tumor type), PET (Positron emission tomography), VATS (Video-assisted thoracoscopic surgery)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: May 13, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: This manuscript has no relevant disclosures in the form of grants, gifts, or other forms of financial support.
Conflicts of Interest: The author has no conflicts of interest to disclose. The author has no relationships with industry.
Authorship: The sole author had access to the data and is responsible for writing the manuscript.
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