Patient case (clinical description): A 61-year-old man comes to the clinic due to nonproductive cough and progressive dyspnea.  The patient's medical conditions include hypertension, hypercholesteremia and peptic ulcer disease.  He smokes 2 packs of cigarettes daily for the past 30 years.  On examination, there are decreased breath sounds and percussive dullness at the base of the left lung.  Other vital signs are normal. Abdomen is soft without tenderness. CT scan shows a left-sided pleural effusion and nodular thickening of the pleura. The plural fluid was bloody on thoracentesis. Biopsy shows proliferation of epithelioid-type cells with very long microvilli.

Patient's own account: I am 61 and I had to go to the clinic because I couldn't stop coughing and I experienced some breath shortness. I suffer from hypertension and cholesterol and I also have a stomach ulcer. I should admit that I've been smoking 2 packs of cigarettes every day for the past 30 years. My doctor told me that my breath in my left lung sounds bad. But he told me that my blood pressure, heart rate, breathing rate and temperature are normal. My belly is also normal. However my X-Rays show some liquid on the left side and a mass where the liquid got hard. The scary thing is that the liquid was bloody when they got it out. They did a biopsy and it showed that I have an increase of epithelioid-type cells with very long microvilli.

Clinical trial: Management of Malignant Pleural Effusion - Indwelling Pleural Catheter or Talc Pleurodesis

Eligibility criteria:
Inclusion Criteria:

          1. Patients with recurrent symptomatic pleural effusion, the diagnosis was obtained by :
             - positive cytology for malignant cells in the fluid.

               -  patients well known for malignancy, with exudative pleural effusion with no
                  alternative diagnosis.

               -  pleural biopsy - surgically obtained - with diagnosis of pleural malignancy

               -  microscopic intraoperative findings suggestive of pleural malignancy.

          2. Patients who underwent prior to involvement in the study, draining of the pleural
             fluid with symptomatic improvement.

          3. Patients with rate of fluid accumulation less than 30 days.

          4. Patient who signed informed consent about being involved in the study.

        Exclusion Criteria:

          1. Patients under the age of 18 years.

          2. Female patients who are Pregnant or nursing.

          3. Patients with rate of pleural effusion accumulation is more than 30 days.

          4. Patients who didn't show clinical improvement post proper draining of the fluid

          5. Patients who are hemodynamically or respiratory unstable.

          6. Patients with Empyema.

          7. Patients who are non functioning/ not active according to the Performance status.

          8. The type of malignancy which cause the malignant pleural effusion is Lymphoma.

          9. Patient who underwent pneumonectomy at the side of the fluid.

         10. previous pleurodesis at the side of pleural effusion.

         11. Chylothorax in the initial pleural tapping.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 90 Years

Eligibility (NLI label): Entailment