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Review
. 2013 May;110(18):313-8.
doi: 10.3238/arztebl.2013.0313.

The treatment of pleural carcinosis with malignant pleural effusion

Michael Ried  1 , Hans-Stefan Hofmann
Affiliations
Review

The treatment of pleural carcinosis with malignant pleural effusion

Michael Ried et al. Dtsch Arztebl Int. 2013 May.

Abstract

Background: Pleural carcinosis is caused by tumors of the chest (e.g., lung and breast cancer) or elsewhere in the body (e.g., ovarian carcinoma) that metastasize to the visceral and/or parietal pleura. Recurrent malignant pleural effusion due to pleural carcinosis is one of the most common findings in oncology. It affects about 56 000 patients per year in Germany alone.

Methods: This review is based on pertinent literature retrieved by a selective search of the Medline database (key words: malignant pleural effusion, pleural carcinosis) and on the authors' clinical experience.

Results: Although many retrospective studies have been published, there has been only one randomized controlled trial of treatment, in which permanent pleural catheters were compared with talcum pleurodesis. Patients with pleural carcinosis have a median survival of less than 12 months. Many are suffering from progression of their underlying disease, with generalized tumor involvement; thus, the symptomatic treatment of pain and dyspnea is often the main therapeutic issue. The underlying tumor, usually an adenocarcinoma, can be diagnosed either by histology or by cytology. The main complication is progressive respiratory failure. The treatment is palliative, rather than curative. The main approaches are drainage of the effusion (by thoracocentesis or with permanent pleural catheters) and pleurodesis (obliteration of the pleural space by causing the visceral and parietal pleura to adhere to each other).

Conclusion: Pleural carcinosis with symptomatic malignant pleural effusion is treated palliatively. The appropriate treatment in each case should be determined through discussion with the patient, with the goal of improving the patient's quality of life.

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Figures

Figure 1
Figure 1
Right-side pleural effusion in a patient with breast cancer
Figure 2
Figure 2
Left-side pleural carcinosis with malignant pleural effusion and condition following primary insertion of chest drain
Figure 3
Figure 3
Thoracoscopic evidence of pleural carcinosis in a cytologically- confirmed malignant pleural effusion prior to scheduled talc pleurodesis
Figure 4
Figure 4
Indwelling subcutaneous tunneled pleural catheter
See this image and copyright information in PMC

Comment in

References

    1. Kaifi JT, Toth JW, Gusani NJ, et al. Multidisciplinary management of malignant pleural effusion. Journal Surg Oncol. 2012;105:731–738. - PubMed
    1. Loddenkemper R. Management der malignen Pleuraergüsse. Pneumologie. 2005;59:120–135. - PubMed
    1. Stoelben LE. Surgical therapy for malignant pleural effusions. Zentralbl Chir. 2008;133:218–221. - PubMed
    1. Mishra E, Davies HE, Lee YCG. Malignant pleural disease in primary lung cancer. In: Spiro SG, Janes SM, Huber RM, editors. Thoracic Malignancies. Sheffield, UK: European Respiratory Society Journals Ltd; 2009. pp. 318–335.
    1. Antony VB, Loddenkemper R, Astoul P, et al. Management of malignant pleural effusions. Eur Respir J. 2001;18:402–419. - PubMed