A 71-year-old man presented to the hospital with chest pain and dyspnea worsening
over the past few months. His medical and surgical history included end-stage renal
disease with deceased donor kidney transplant five years ago, well-controlled human
immunodeficiency virus infection, and hepatitis C virus infection complicated by hepatocellular
carcinoma (HCC) which was treated with surgical resection two years ago. Imaging revealed
a large, loculated right pleural effusion, a calcified right mediastinal mass, multiple
liver lesions, and lytic bony lesions of ribs, spine, and pelvis. Biopsy of a liver
lesion revealed well-differentiated HCC. Endobronchial ultrasound-guided biopsy of
the calcified mediastinal mass was nondiagnostic. Thoracentesis of the right pleural
effusion revealed an exudative effusion with no malignant cells observed on cytology
after multiple samples. An indwelling pleural catheter was placed, and the patient
was discharged with plans for outpatient therapy for metastatic HCC.
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References
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Article info
Publication history
Published online: February 19, 2022
Accepted:
February 16,
2022
Received:
August 4,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
