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Large unilateral pleural effusion is a very common mode of presentation of lung malignancy to physicians. Treatment of malignant pleural effusion usually involves some form of pleural intervention, typically either insertion of an intercostal drain and talc pleurodesis or alternatively placement of an indwelling pleural catheter depending on the presence of trapped lung, planned oncological therapy, patient comorbidities and estimated life expectancy.1 Occasionally, rapid removal of large amounts of pleural fluid can result in sudden re-expansion pulmonary oedema (RPO). Recognition of this rare complication is important to deliver the specific required treatment.
A 72-year-old man with known metastatic lung adenocarcinoma (to brain, bone and liver) presented 2 months later with increased dyspnoea due to a large right-sided pleural effusion demonstrated on his chest radiograph …
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