Retrospective analysis of unknown primary cancers with malignant pleural effusion at initial diagnosis

Abstract

BackgroundMalignant pleural effusion (MPE) can occur during the progression of various cancers. However, factors, such as the incidence of MPE associated with different types of cancers and its potential for diagnosing previously undetected cancers, are unknown. Moreover, MPE may accompany potentially curable cancers or those with a favorable survival prognosis with adequate treatment. The present study determined the types of cancers accompanied by MPE at initial diagnosis and investigated appropriate related methods for diagnosing previously unknown cancers.MethodsWe retrospectively reviewed the medical records of 35 patients with MPE at initial cancer diagnosis between 2004 and 2012. We evaluated the patient characteristics, final diagnosis, and diagnostic processes.ResultsOf the 35 patients, 10 had lung cancer, seven ovarian or peritoneal cancer, four malignant pleural mesothelioma, one breast cancer, one lymphoma, one pancreatic cancer, and 11 had cancers of unknown origin. Diagnoses of the primary lesions were confirmed using the MPE cellblock method for seven of 11 patients (63.6%), by excisional biopsy or aspiration from other sites in four of nine patients, by exploratory laparotomy in two of three patients, and by peritoneal washing cytology in five patients.ConclusionLung cancer and cancer of unknown origin are major causes of MPE at initial presentation. However, these groups also contain cancers that are curable and those with good long‐term prognosis. The MPE cellblock method represents an accurate method for identifying cancer origin.

Metastatic thyroid carcinoma presenting as malignant pleural effusion: A cytologic review of 5 cases

“…1 The most common culprits involved in malignant pleural effusions include lung cancer, followed by breast, lymphoma and others. 1 The most common culprits involved in malignant pleural effusions include lung cancer, followed by breast, lymphoma and others.…”

Evaluation of efficacy and safety for recombinant human adenovirus-p53 in the control of the malignant pleural effusions via thoracic perfusion

“…Malignant pleural effusion (MPE) is one of the common complications of lung cancer, which mainly caused by the hyperpermeability of microvascular tissue or invasion of cancer cells into lymphatic vessels1. Research show that the incidence of malignant effusion in patients with lung cancer is about 7–23%23 and occurs in 15% of cancer-related deaths1, which usually leads to debilitating dyspnoea, worsening quality of life and a poor survival.…”

“…Research show that the incidence of malignant effusion in patients with lung cancer is about 7–23%23 and occurs in 15% of cancer-related deaths1, which usually leads to debilitating dyspnoea, worsening quality of life and a poor survival. However, its treatment is quite difficult2.…”

“…The present treatments of MPE included the drainage of pleural effusion, intrapleural chemotherapy and systemic chemotherapy. Unfortunately, not all patients with MPE can benefit from quasi chemotherapy and treatment123.…”

“…A certain number of studies have been showed that p53 gene transfer has an anti-tumor activity in vitro and in vivo 591011121314. Moreover, a series of studies on p53-based gene therapy have been performed from fundamental research (molecule and cell) to clinical applications (human)191112; for example, a p53-based gene therapy has been approved as part of biological cancer therapy in China15.…”