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Malignant pleural effusion (MPE) as debut of cancer

Ismael Ali García, Beatriz Morales Chacón, Nuria Abad Santamaría, Maria Teresa Río Ramirez, María Isabel Verdugo Cartas, Raquel Pérez Rojo, Eva De Santiago Delgado, Yolanda Martínez Abad, Bárbara Steen, Mercedes Izquierdo Patrón, Rosario Melchor Iñiguez, José Ignacio De Granda Orive, María Beatriz Arias Arcos, Victoria Villena Garrido
European Respiratory Journal 2015 46: PA4345; DOI: 10.1183/13993003.congress-2015.PA4345
Ismael Ali García
1Pulmonology Service, Hospital Infanta Leonor, Madrid, Spain
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Beatriz Morales Chacón
2Pulmonology Service, Hospital Clínico San Carlos, Madrid, Spain
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Nuria Abad Santamaría
3Pulmonology Service, Hospital Severo Ochoa, Madrid, Spain
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Maria Teresa Río Ramirez
4Pulmonology Service, Hospital de Getafe, Madrid, Spain
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María Isabel Verdugo Cartas
5Pulmonology Service, Hospital Infanta Leonor, Madrid, Spain
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Raquel Pérez Rojo
6Pulmonology Service, Hospital de Móstoles, Madrid, Spain
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Eva De Santiago Delgado
7Pulmonology Service, Hospital del Henares, Madrid, Spain
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Yolanda Martínez Abad
8Pulmonology Service, Hospital La Paz, Madrid, Spain
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Bárbara Steen
9Pulmonology Service, Hospital Fundación Alcorcón, Madrid, Spain
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Mercedes Izquierdo Patrón
9Pulmonology Service, Hospital Fundación Alcorcón, Madrid, Spain
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Rosario Melchor Iñiguez
10Pulmonology Service, Hospital Fundación Jimenez Díaz, Madrid, Spain
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José Ignacio De Granda Orive
11Pulmonology Service, Hospital 12 Octubre, Madrid, Spain
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María Beatriz Arias Arcos
1Pulmonology Service, Hospital Infanta Leonor, Madrid, Spain
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Victoria Villena Garrido
11Pulmonology Service, Hospital 12 Octubre, Madrid, Spain
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Abstract

Introduction and Objective: To evaluate the clinical manifestations, diagnostic techniques, histology and location of the primary tumor of patients with MPE as debut of cancer.

Methods: 402 consecutive patients diagnosed of malignant pleural effusion as debut of cancer were studied retrospectively (2008-2013) in a multi-centric study.

Results: median age 70 years, 241 males. Main symptoms were dyspnea 81.1%, chest pain 47.8%, cough 44.3%, weight loss 36.6%, extrathoracic symptoms 34%, fever 9.2 and hemoptysis 2.2%. The location of the primary tumor was: lung 53.5%, pleural 20.4%, gynecological 6.5%, haematological 6.5%, gastrointestinal 3.2%, breast 1%, urological 7.9%, unknown 1%. The histologycal type were: adenocarcinoma 58%, mesothelioma 18,9%, carcinoma 7.2%, lymphoma 5.2%, small cell 5%, non small cell 2.46%, squamous cell carcinoma 1.5%, leukemia 1.24% and sarcoma 0.5%.

TechniqueThoracocentesis (A)closed pleural biopsy (B)Pleural biopsy ultrasound-assisted (C)thoracoscopy (D)thoracotomy (E)
Number (%)400 (99,5)138 (34.3)36 (9)69 (22,9)4 (1)
Yield67,5%48,5%55,5%100%100%
Screening for malignancy242(60,3%)44 (10.9%)15 (3.7%)69 (17.2%)4 (1%)
(A)+(B) 23 (5.7%)(A)+(C) 5 (1.2%)

The diagnostic techniques were:

Conclusions: The MPE as a diagnosis of unknown primary tumor was more common in men of advanced age. The predominant symptom was dyspnea. The thoracentesis was higher diagnosis yield than the closed pleural biopsy. Pleural mesothelioma and lung adenocarcinoma histologic subtypes were the most common sites.

  • Pleura
  • Lung cancer / Oncology
  • Copyright ©ERS 2015
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Malignant pleural effusion (MPE) as debut of cancer
Ismael Ali García, Beatriz Morales Chacón, Nuria Abad Santamaría, Maria Teresa Río Ramirez, María Isabel Verdugo Cartas, Raquel Pérez Rojo, Eva De Santiago Delgado, Yolanda Martínez Abad, Bárbara Steen, Mercedes Izquierdo Patrón, Rosario Melchor Iñiguez, José Ignacio De Granda Orive, María Beatriz Arias Arcos, Victoria Villena Garrido
European Respiratory Journal Sep 2015, 46 (suppl 59) PA4345; DOI: 10.1183/13993003.congress-2015.PA4345

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Malignant pleural effusion (MPE) as debut of cancer
Ismael Ali García, Beatriz Morales Chacón, Nuria Abad Santamaría, Maria Teresa Río Ramirez, María Isabel Verdugo Cartas, Raquel Pérez Rojo, Eva De Santiago Delgado, Yolanda Martínez Abad, Bárbara Steen, Mercedes Izquierdo Patrón, Rosario Melchor Iñiguez, José Ignacio De Granda Orive, María Beatriz Arias Arcos, Victoria Villena Garrido
European Respiratory Journal Sep 2015, 46 (suppl 59) PA4345; DOI: 10.1183/13993003.congress-2015.PA4345
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More in this TOC Section

  • Comparison between mesothelin and fibulin-3 detection in pleural malignant mesothelioma (MPM) patients
  • A comparative study of conventional cytology and cell block method in the diagnosis of pleural effusion
  • An examination of the factors for successful pleurodesis against malignant pleural effusion (MPE)
Show more 11.2 Pleural and Mediastinal Malignancies

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