Malignant Pleural Effusion Pathophysiology, Causes, Epidemiology, and Therapies: Updates Review

Abstract

Background. Pleural effusion (PE) is frequently seen in ordinary medical practice, often resulting from various underlying pathological conditions. Lung cancer is the primary etiology of malignant PE, with breast cancer ranking second in prevalence. PE is mostly attributed to many prevalent etiologies, in-cluding congestive heart failure, parapneumonia, paramalignant, empyema, and pulmonary embolism. Pleural fluid aspiration facilitates the distinction between various forms of PEs. In addition to addressing the primary pathology, malignant PE management encompasses a spectrum of interventions, including antibiotics, pleurodesis, video-assisted thoracoscopy, early thoracic surgeon consultation, thoraco-scopy, and the insertion of a long-term indwelling pleural catheter. Methods. The evaluation presented below is predicated upon relevant literature published between Jan 2020 and Sept 2023, obtained by a meticulous PubMed, Google, and Google Scholar search for updates about malignant PEs. We used different keywords and expressions concerning malignant PE. We aim to review the pathophysiology, epidemiology, and therapy updates of malignant PEs. The appropriate management of malignant PE requires a thorough exclusion of other differential diagnoses. The available therapy choices have been expanded significantly. These therapeutic choices are affected by the underlying pathology. Despite the great changes in malignant PE treatment, the anticipated future diagnostic tests for the causation of the effusion, enhanced pleurodesis agents, advancements in interventional procedures, and the genetic makeup of the afflicted individuals are expected to expand, dynamically altering the diagnostic and therapeutic choices.