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Malignant pleural effusion — SCE Respiratory MCQ

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HardPleural DiseaseMalignant pleural effusionSCE Respiratory

A patient with biopsy-proven malignant pleural mesothelioma has undergone medical thoracoscopy and indwelling pleural-catheter insertion. The procedure tracts are asymptomatic. What should be offered to prevent tract metastases?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Observe the procedure tracts without routine prophylactic radiotherapy

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · C = shown as D · A = shown as E

E is correct. BTS recommends against routine prophylactic radiotherapy to chest-wall procedure tracts in malignant pleural mesothelioma. Randomised evidence did not show sufficient prevention of clinically important tract metastases. Hemithorax irradiation, routine tract excision, mandated three-fraction treatment and corticosteroid injection are not recommended preventive strategies; focal radiotherapy can be used for troublesome local pain or tract disease.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC5844375/