Malignant Pleural Effusion

A build-up of extra fluid in the pleural space, which is the space between the lungs and the chest wall, is considered to be one of the symptoms of cancer and, if any cancer cells are present in this fluid collection, it is called the malignant pleural effusion. MPE symptoms include shortness of breath, fever, etc. Malignant pleural effusion treatment aims to remove the fluid from the chest and prevent it from re-accumulating in there. More detailed information about this condition, as well as MPE symptoms, diagnostic services and malignant pleural effusion treatment options, is presented below.

A pleural effusion is a buildup of extra fluid in the pleural space, which is the space between the lungs and the chest wall. About half of people with cancer develop a pleural effusion. Cancer growing in the pleural space causes a malignant pleural effusion.

More than 75% of people with a malignant pleural effusion have lymphoma or cancers of the breast, lung, or ovary. This condition is considered a sign of metastatic cancer, or cancer that has spread to other areas of the body. Although a malignant pleural effusion is treatable, it can be a serious, potentially life-threatening condition.


  • Shortness of breath
  • Pain in chest (especially on breathing in deeply)
  • Fever
  • Cough

Due to the fact that this condition is also normally caused by other underlying medical conditions, symptoms of those conditions may be present as well.


Drainage of the pleural fluid

This is the first choice treatment and is performed via a procedure known as thoracentesis (may be both diagnostic and therapeutic). A tube is inserted into the effusion and is drained out. Monitoring is required for this procedure and in some instances; the tube may have to be remained in the pleural space for an extended period of time for continued drainage. Repeated thoracentesis may vary from patient to patient depending on the underlying cause, the amount of effusion fluid, the type of effusion and whether there is a recurrence.

Video-assisted thoracoscopic surgery

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest. During a video-assisted thoracoscopic surgery procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through several small incisions. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure.


  • History taking and Physical examination: Your general health will be accessed and the symptoms you’ve been experiencing will be discussed.
  • Chest X-ray: X-ray of the inside of the body will show the buildup of fluid
  • Computed tomography (CT or CAT): A three-dimensional picture of the inside of the body is created with an x-ray machine to get a clearer view
  • Ultrasound: Sound waves are used to create a picture of the inside of the body
  • Thoracentesis: Removal and analysis of fluid from the pleural cavity using a needle
  • Flexible pleuroscopy: A Pleuroscopy is a medical examination that allows your doctor to visualise the space between your lung and the chest wall, called the pleural cavity. The pleural cavity facilitates the optimal performance of the lungs during breathing. An instrument called a Pleuroscope, which consists of a thin tube attached to a camera, is inserted through the chest wall. The procedure does not usually require general anaesthesia. It is done using conscious sedation (medication that makes you sleepy and relaxed). Sometimes an ultrasound may be used to determine the most suitable point for the Pleuroscope entry. Pleuroscopy is used to diagnose the cause of the abnormal build-up of fluid in the pleural cavity. Using flexible Pleuroscopy, your doctor can visualise the pleural cavity and perform biopsies (collection of tissue specimens of the lung), while guided by video images, in order to diagnose the cause of fluid accumulation. Medications can sometimes be sprayed onto the pleural surface during the procedure to stop fluid re-accumulation.