An Elusive Case of Pleural Effusion
The incidence of distant metastasis in head and neck Squamous Cell Carcinoma (SCC) is relatively low. The most frequently involved sites for distant metastasis are lungs, followed by bone and liver. The most important predictive factors for distant metastasis appear to be site of the primary tumour...
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JCDR Research and Publications Private Limited
2023-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/17612/59392_CE[Ra1]_F(IS)_PF1(AG_SS)_PFA(AG_KM)__PN(KM).pdf |
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| author | Nazia Banu Ziaullah Koushik Muthu Raja Venkatachalam Govindasaami Vinod Dhanasekar Thangaswamy Rathish |
| author_facet | Nazia Banu Ziaullah Koushik Muthu Raja Venkatachalam Govindasaami Vinod Dhanasekar Thangaswamy Rathish |
| author_sort | Nazia Banu Ziaullah |
| collection | DOAJ |
| description | The incidence of distant metastasis in head and neck Squamous Cell Carcinoma (SCC) is relatively low. The most frequently involved sites for distant metastasis are lungs, followed by bone and liver. The most important predictive factors for distant metastasis appear to be site of the primary tumour (hypopharynx), advanced T- and N-classification, locoregional control and histologic grade. A 61-year-old male, chronic smoker, presented with complaints of grade 4 mMRC (Modified Medical Research Council) dyspnoea. He had left-sided buccal mucosal SCC (locally advanced) and was on palliative chemotherapy. He had undergone treatment for pulmonary tuberculosis seven years back. He was tachypneic and clinical examination revealed absent breath sounds in the left hemithorax. Chest radiograph showed a massive left pleural effusion which was found to be exudative after therapeutic thoracocentesis. Cytology tests were negative for malignant cells. Positron Emission Tomography (PET) scan showed uptake along the left pleura (SUV Max-5.06) and left buccal mucosa (SUV Max -4.1). Thoracoscopic frozen section pleural biopsy revealed metastatic squamous cell carcinomatous deposits in the pleura. On table pleurodesis was done with doxycycline. The patient was continued on palliation with no recurrent effusion. However, he succumbed to the disease after eight months. This case report describes a rare case of malignant pleural effusion from a primary buccal mucosal SCC without any concurrent lung involvement. |
| first_indexed | 2024-04-09T21:01:32Z |
| format | Article |
| id | doaj.art-180dc0e827aa4cf4be7472a1a12fba64 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-09T21:01:32Z |
| publishDate | 2023-03-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-180dc0e827aa4cf4be7472a1a12fba642023-03-29T09:00:33ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-03-01173OD10OD1210.7860/JCDR/2023/59392.17612An Elusive Case of Pleural EffusionNazia Banu Ziaullah0Koushik Muthu Raja1Venkatachalam Govindasaami Vinod2Dhanasekar Thangaswamy3Rathish4Postgraduate Student, Department of Pulmonology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.Professor/Deputy Medical Director, Department of Pulmonology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.Assistant Professor, Department of Pulmonology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.Professor and Head, Department of Pulmonology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.Senior Resident, Department of Pulmonology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.The incidence of distant metastasis in head and neck Squamous Cell Carcinoma (SCC) is relatively low. The most frequently involved sites for distant metastasis are lungs, followed by bone and liver. The most important predictive factors for distant metastasis appear to be site of the primary tumour (hypopharynx), advanced T- and N-classification, locoregional control and histologic grade. A 61-year-old male, chronic smoker, presented with complaints of grade 4 mMRC (Modified Medical Research Council) dyspnoea. He had left-sided buccal mucosal SCC (locally advanced) and was on palliative chemotherapy. He had undergone treatment for pulmonary tuberculosis seven years back. He was tachypneic and clinical examination revealed absent breath sounds in the left hemithorax. Chest radiograph showed a massive left pleural effusion which was found to be exudative after therapeutic thoracocentesis. Cytology tests were negative for malignant cells. Positron Emission Tomography (PET) scan showed uptake along the left pleura (SUV Max-5.06) and left buccal mucosa (SUV Max -4.1). Thoracoscopic frozen section pleural biopsy revealed metastatic squamous cell carcinomatous deposits in the pleura. On table pleurodesis was done with doxycycline. The patient was continued on palliation with no recurrent effusion. However, he succumbed to the disease after eight months. This case report describes a rare case of malignant pleural effusion from a primary buccal mucosal SCC without any concurrent lung involvement.https://jcdr.net/articles/PDF/17612/59392_CE[Ra1]_F(IS)_PF1(AG_SS)_PFA(AG_KM)__PN(KM).pdfbuccal mucosal carcinomadyspnoeapleural biopsypleural metastasispleurodesis |
| spellingShingle | Nazia Banu Ziaullah Koushik Muthu Raja Venkatachalam Govindasaami Vinod Dhanasekar Thangaswamy Rathish An Elusive Case of Pleural Effusion Journal of Clinical and Diagnostic Research buccal mucosal carcinoma dyspnoea pleural biopsy pleural metastasis pleurodesis |
| title | An Elusive Case of Pleural Effusion |
| title_full | An Elusive Case of Pleural Effusion |
| title_fullStr | An Elusive Case of Pleural Effusion |
| title_full_unstemmed | An Elusive Case of Pleural Effusion |
| title_short | An Elusive Case of Pleural Effusion |
| title_sort | elusive case of pleural effusion |
| topic | buccal mucosal carcinoma dyspnoea pleural biopsy pleural metastasis pleurodesis |
| url | https://jcdr.net/articles/PDF/17612/59392_CE[Ra1]_F(IS)_PF1(AG_SS)_PFA(AG_KM)__PN(KM).pdf |
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