Refractory left pleural effusion in an older patient: Atypical presentation of colorectal carcinoma.

Abstract

The current study reports the case of a 60-year-old male that presented with a four-month history of recurrent chest pain. Chest X-ray examination revealed a left-sided pleural effusion. A closed thoracic drainage procedure was performed, but the chest pain relapsed shortly afterwards. The pleural fluid was exudative, with no tumor cells detected. A computed tomography scan subsequently revealed a large mass located in the splenic curve of the colon, with involvement of the greater curvature of the stomach. Endoscopic biopsies confirmed the diagnosis of adenocarcinoma. A gastrointestinal stromal tumor was excluded by endoscopic ultrasonography and biopsy. A subtotal colectomy with partial excision of the stomach, diaphragm and left liver lobe was successfully performed, followed by the administration of six cycles of adjuvant chemotherapy. At present, the patient is asymptomatic and there is no evidence of tumor recurrence following a 12-month follow-up. The present study summarizes the characteristics of refractory left pleural effusion by colorectal malignancies.