Pleural effusion arising from a rare pancreatic neoplasm

Abstract

To the Editors: Pleural effusions are common entities and may complicate a number of disease processes. We present the case of a large pleural effusion associated with a rare pancreatic neoplasm. The patient, a 67-yr-old female, was referred for respiratory opinion by the Breast Cancer Service at St Vincent’s University Hospital (Dublin, Ireland). She had a background of invasive ductal carcinoma of the right breast 4 yrs previously for which she had undergone a wide local excision and was taking hormonal therapy. Other past medical history included a diagnosis of seropositive rheumatoid arthritis requiring only analgesic therapy. She had known tuberculosis (TB) exposure in childhood and was a nonsmoker. She drank alcohol only on occasion. She had initially noticed that she was sinking to the left side while swimming over the previous month. This was followed by progressive dyspnoea on exertion, left-sided chest pain and nocturnal non-productive cough. She denied haemoptysis or weight loss and was systemically well. Physical examination identified stony-dull percussion and reduced breath sounds over the mid-lower left lung. She was comfortable at rest with oxygen saturations of 96% on room air. There was no clubbing or lymphadenopathy. A chest radiograph confirmed a large left-sided pleural effusion (fig. 1a). Pleural …