Abstract
Background: Massive pleural effusion occurs in association with malignancy. In Western countries, lung cancer is the leading cause of death, and 8-15% of cancer patients require treatment in an intensive care unit.
 Case presentation: A 56-year-old woman has complained of increased shortness of breath for the past three days. Lung examination from percussion found dullness on the right, resonance on the left, palpation decreased vocal fremitus on the right and auscultation, Diminished or absent breath sounds on the right, and bronchovesicular breath sounds on the left. Chest X-ray examination results with the conclusion of massive pleural effusion dextra. Bronchoscopy was performed under general anesthesia (GA), and a pigtail catheter was inserted. One day after bronchoscopy, a repeat thoracic X-ray was performed with the impression of atelectasis in the right lung, and a bronchoscopy and bronchial toilet were planned. 
 Conclusion: Pleural effusion with lung tumor and atelectasis are common cases in critical care. The management provided can help in reducing patient morbidity.
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