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Pleural Cancer


Presentation

  • Here, we present two cases of breast cancer relapses after 21 and 14 years of DFS and MPE secondary to pleural metastasis. Case Report Case 1 A 74‐year‐old female presented to her cardiologist with a 6‐week history of worsening dyspnoea on exertion.[onlinelibrary.wiley.com]
  • A 91‑year‑old male patient presented with shortness of breath due to massive right pleural fluid.[spandidos-publications.com]
  • Presentation Shortness of breath. Patient Data Age: 80 years Gender: Male Numerous nodular appearing masses expand the pleural cavity and widen the mediastinum. Loading images...[radiopaedia.org]
  • Fentiman et al. (8) found that the mean interval between the diagnosis of the primary tumor and the presentation of pleural effusion was 41.5 months, and that the mean survival after the presentation of pleural effusion was 15.7 months.[scielo.br]
  • Table 2 Patients’ pathological characteristics. 3.2 Study group All together, 70 patients presented a pleural extension classified as M1a disease.[academic.oup.com]
Camping
  • Rosell R, Gómez-Codina J, Camps C, Javier Sánchez J, Maestre J, Padilla J, et al. Preresectional chemotherapy in stage IIIA non-small-cell lung cancer: A 7-year assessment of a randomized controlled trial. Lung Cancer 1999;26:7-14. 21.[cancerjournal.net]
Sputum
  • Abstract We present a case of 55-year-old man who complained of dyspnea and sputum for a month. He was an ex-smoker with a history of prostate cancer and pulmonary tuberculosis.[ncbi.nlm.nih.gov]
  • In 2005, Matsuguma et al. reported that PTNB could cause a higher pleural recurrence rate (9.1%) than bronchoscopy biopsy and sputum (1%) in patients with resected stage I non-small cell lung cancer 7.[nature.com]
Respiratory Insufficiency
  • Post-operative complications occurred including heart arrhythmia, respiratory insufficiency and bacterial infection of residual lung, chylothoraxin and mental disorder.[cancerjournal.net]
Photosensitivity
  • In our study, we used Porfimer sodium (Photofrin; Axcan Pharma Inc, Birmingham, AL, USA), a first-generation photosensitizer. 630 nm red light can activate the photosensitizer.[journals.plos.org]
Claustrophobia
  • This is a difficult examination for critically sick patients or those with claustrophobia. VI. What are the contraindications for the alternative imaging techniques? Noncontrast CT Renal failure increases the risk of contrast induced nephropathy.[cancertherapyadvisor.com]
Incontinence
  • Two years prior, the patient presented with a low back pain and anal incontinence. The tumor appeared to replace most of the prostate and spread to perirectal area and bilateral pelvic wall on computed tomography (CT) ( Fig. 1A ).[ncbi.nlm.nih.gov]

Workup

  • Her cardiac workup was negative, including an ejection fraction of 60–65% on echocardiography. However, chest X‐ray showed right‐sided pleural effusion. She was therefore sent to Interventional Pulmonology for further workup.[onlinelibrary.wiley.com]
  • Third, there is inherent uncertainty with regard to clinical staging when using the NCDB, especially given that different institutions may require different degrees of staging workup and that clinical staging of mesothelioma is notoriously inaccurate.[ascopubs.org]
Mediastinal Shift
  • Large effusions will cause a mediastinal shift. Common etiologies, such as congestive heart failure, are easily detected. The lateral decubitus radiograph is able to detect as little as 10 mL of fluid.[cancertherapyadvisor.com]

Treatment

  • After treatment After treatment is completed, your doctor should provide you with a treatment summary that details the care you received, including: diagnostic tests performed and their results types of treatment used and when they were performed treatment[cancerpathways.org.au]
  • Your treatment team will let you know if you can receive an innovative investigational treatment by participating in a clinical trial.[nyp.org]
  • Treatment for Pleural Cancer Treatment options for unknown primary pleural cancer depend on the cancer’s precise location and stage; the patient’s overall health, goals, and preferences; and other factors.[utswmed.org]
  • Due to the poor prognosis, more invasive treatments, such as pleurectomy, or treatments with major adverse side effects, like chemotherapy, are usually not considered.[onlinelibrary.wiley.com]

Prognosis

  • It is associated with a poorer prognosis and the most common symptoms are dyspnoea and cough. Treatment options depend on multiple factors including patient symptoms, performance status, prognosis and speed of reaccumulation of the pleural fluid.[bccancer.bc.ca]
  • Studies of the spread of breast cancer have shown that a longer interval free of pleural metastases is an indicator of a worse prognosis, (8,10,11) and this poor prognosis has been associated with factors such as the site of the metastasis and the identification[scielo.br]
  • Such findings alter the prognosis, staging, and treatment of that large group of patients.[academic.oup.com]
  • Outlook (Prognosis) The expected outcome depends upon the underlying disease. Possible Complications A lung surrounded by a fluid collection for a long time may collapse.[uclahealth.org]
  • Due to the poor prognosis, more invasive treatments, such as pleurectomy, or treatments with major adverse side effects, like chemotherapy, are usually not considered.[onlinelibrary.wiley.com]

Etiology

  • Common etiologies, such as congestive heart failure, are easily detected. The lateral decubitus radiograph is able to detect as little as 10 mL of fluid. This is a simple and cost-effective examination for diagnosis.[cancertherapyadvisor.com]
  • Neoplastic etiology of pleural efussion needs histopathological confirmation. We present three cases that illustrate various etiologies for pleural effusions in patients with ovarian tumors: thromboembolism, malignancy and Meigs syndrome.[pneumologia.eu]
  • Lung cancer is the most common etiology for MPE, followed by breast cancer.[cancertm.com]
  • On the contrary, however, pleural fluid due to thyroid cancer is a rare etiology, to our knowledge, and only 51 cases have been reported ( 3 – 19 ).[spandidos-publications.com]
  • There is no evidence of neural crest origin. [32] There are no known etiologic factors.[emedicine.medscape.com]

Epidemiology

  • Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283, 2008–2012, (2000). 16.[nature.com]
  • Relationship between epidemiologic risk factors and breast cancer recurrence. J Clin Oncol. 2007;25(28):4438-44. PMid:17785707. [ Links ] 20. Cadaval Gonçalves AT, Costa Jobim PF, Vanacor R, Nunes LN, Martins de Albuquerque I, Bozzetti MC.[scielo.br]
  • Author information Affiliations Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos, Madrid, 5 28029, Spain Gonzalo López-Abente , Pablo Fernández-Navarro , Rebeca Ramis , Javier[bmccancer.biomedcentral.com]
  • Flores RM, Riedel E, Donington JS, et al: Frequency of use and predictors of cancer-directed surgery in the management of malignant pleural mesothelioma in a community-based (Surveillance, Epidemiology, and End Results [SEER]) population.[ascopubs.org]
  • Epidemiology Pleural tumors are a small but significant subset of thoracic malignancies. The majority of pleural tumors tend to be malignant and mesothelioma is the most common diagnosis. Most patients have had environmental exposure to asbestos.[accesssurgery.mhmedical.com]
Sex distribution
Age distribution

Pathophysiology

  • This review addresses the pathophysiology of MPE and the treatment options for patients with MPE. Keywords: Cancer, malignant pleural effusion, palliative treatment, pathophysiology How to cite this article: Liu C, Qian Q, Geng S, Sun W, Shi Y.[cancertm.com]
  • Miserocchi G: Physiology and pathophysiology of pleural fluid turnover. Eur Respir J 1997;10:219–225. Jantz MA, Antony VB: Pathophysiology of the pleura. Respiration 2008;75:121–133.[karger.com]
  • Pathophysiology Pleural tumors are generally characterized as benign or malignant.[accesssurgery.mhmedical.com]

Prevention

  • Surgery is often necessary to drain fluid and prevent it from building up again. Learn more about pleural effusion.[brighamandwomens.org]
  • Treatment Treatment may be directed at removing the fluid, preventing its re-accumulation, or addressing the underlying cause of the fluid buildup.[uclahealth.org]
  • It can also be used to prevent cancer. Surgery The aim of surgery is to confirm the diagnosis and to treat the fluid in the chest to try and prevent it from coming back by sticking the lung to the inside of the chest wall (a pleurodesis).[cancerpathways.org.au]
  • Insertion of a shunt, which bypasses or diverts excess fluid from 1 place to another Treating the cancer with chemotherapy to prevent the effusion from returning Related Resources Side Effects Advanced Cancer Care Planning[cancer.net]
  • He then had a pleurodesis operation to prevent blood and other fluid accumulating in the pleural space.[healthtalk.org]

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