Asymptomatic malignant pleural effusion: to observe or to manage

The malignant pleural effusion (MPE) incidence in the United States is estimated to be more than 150,000 cases annually (1). Most of the MPEs are symptomatic and commonly present with dyspnea, dry cough, dull chest pain and constitutional symptoms (2). While there is a fair amount of data about symptomatic MPEs, including epidemiology, clinical presentation and treatment options, the management of asymptomatic MPEs is mostly through observation (3,4).