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Malignant pleural effusion with expandable lung — SCE Respiratory MCQ

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ModeratePleural DiseaseMalignant pleural effusion with expandable lungSCE Respiratory

A 70-year-old man has recurrent symptomatic malignant pleural effusion from lung adenocarcinoma. After 1.5 L aspiration, his lung fully re-expands and he remains breathless when fluid returns after 2 weeks. He wants a treatment with a high chance of avoiding a long-term external catheter. What is the most appropriate management?

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Correct answer: B — Talc pleurodesis after therapeutic drainage

Recurrent symptomatic malignant effusion with expandable lung is suitable for talc pleurodesis if the patient prefers avoiding a long-term catheter. IPC is also reasonable, but the preference and full lung expansion favour pleurodesis. Diuretics, repeated diagnostic taps and pleural radiotherapy are not definitive effusion-control strategies.

Reference: BTS Pleural Disease Guideline 2023