A Narrative Review-Management of Malignant Pleural Effusion Related to Malignant Pleural Mesothelioma

Heart Lung Circ. 2023 May;32(5):587-595. doi: 10.1016/j.hlc.2023.02.004. Epub 2023 Mar 14.

Abstract

Malignant pleural mesothelioma (MPM) is an aggressive, almost universally fatal cancer with limited therapeutic options. Despite efforts, a real breakthrough in treatment and outcomes has been elusive. Pleural effusion with significant breathlessness and pain is the most typical presentation of individuals with MPM. Although thoracentesis provides relief of breathlessness, most such pleural effusions recur rapidly, and a definitive procedure is often required to prevent a recurrence. Unfortunately, the optimal treatment modality for individuals with recurrent MPM-related effusion is unclear, and considerable variation exists in practice. In addition, non-expandable lung is common in pleural effusions due to MPM and makes effective palliation of symptoms more difficult. This review delves into the latest advances in the available management options (both surgical and non-surgical) for dealing with pleural effusion and non-expandable lung related to MPM. We discuss factors that determine the choice of definitive procedures that need to be tailored to the individual patient.

Keywords: Malignant pleural effusion; Malignant pleural mesothelioma; Non-expandable lung.

Publication types

  • Review

MeSH terms

  • Humans
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / therapy
  • Mesothelioma* / complications
  • Mesothelioma* / diagnosis
  • Mesothelioma* / therapy
  • Mesothelioma, Malignant*
  • Pleural Effusion* / pathology
  • Pleural Effusion, Malignant* / etiology
  • Pleural Effusion, Malignant* / therapy
  • Pleural Neoplasms* / complications
  • Pleural Neoplasms* / diagnosis
  • Pleural Neoplasms* / therapy