Pleural malignancies, primary or metastatic, portend a grim prognosis. In addition to the serious oncologic implications of a pleural malignancy, these tumors can be highly symptomatic. A malignant pleural effusion can cause dyspnea, secondary to lung compression, or even tension physiology from a hydrothorax under pressure. The need to palliate these effusions is a seemingly straightforward clinical scenario, but with nuances that can result in disastrous complications for the patient if not attended to appropriately. Solid pleural malignancies can cause great pain from chest wall invasion or can cause a myriad of morbid symptoms because of the invasion of thoracic structures, such as the heart, lungs, or esophagus. This article reviews pleural malignancies, the purely palliative treatments, and the treatments that are performed with definitive (curative) intent.
⁎Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
†Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA
Address reprint requests to Keith A. Cengel, MD, PhD, Department of Radiation Oncology, University of Pennsylvania School of Medicine, 180G John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA 19104