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- Title
Managing malignant pleural effusion – a challenging case of metastatic lung cancer.
- Authors
Siminiceanu, Crina-Maria; Dumitrescu, Elena-Adriana; Gheorghe, Adelina-Silvana; Bălașa, Mihai; Kajanto, Lidia-Anca; Ciontea, Loredana-Maria; Stolojanu, Anca-Alexandra; Matei, Radu; Prundianu, Sânziana; Stănculeanu, Dana-Lucia
- Abstract
Malignant pleural effusion (MPE) is a frequent complication in lung carcinoma, especially in adenocarcinoma. In this case report, we present the case of a 62-year-old male diagnosed with metastatic NSCLC, who underwent corpectomy of tumoral L4 vertebrae with implantation of titan cages for cauda equina syndrome. The initial imagistic evaluation showed a right pulmonary mass with multiple pulmonary metastasis, bone metastasis and minimum right pleural effusion, measuring 3 mm. The patient experienced chronic symptoms: right chest pain, shortness of breath while laying down, and coughs with gradual increase. Chest CT showed a right-sided massive pleural effusion and complete lung atelectasis with mass effect, resulting in mediastinal shift to the left side. Emergency thoracocentesis was performed and the cytology confirmed the malignant pleural effusion, but with Staphylococcus aureus suprainfection (MRSA). Aggressive antibiotic therapy was initiated and regular chest X-rays were done, with a partial expansion of the lung and a minimal regression of the pleural effusion, known as trapped lung syndrome. Further, an indwelling pleural catheter was required, with a moderate regression of the pleural effusion, subsequently improving the general condition of the patient. MPE is present in approximatively 15% of lung cancer patients at diagnosis, and thoracocentesis is the investigation needed for confirmation. This case report highlights the complexities of malignant pleural effusion, the therapeutic approaches and the importance of personalized therapy for a better outcome.
- Subjects
PLEURAL effusions; LUNG cancer; CAUDA equina syndrome; METASTASIS; IMPLANTABLE catheters; DYSPNEA
- Publication
Oncolog-Hematolog, 2023, Issue 64, p46
- ISSN
2066-8716
- Publication type
Article