From the Research
Yes, hepatocellular carcinoma (HCC) can cause pleural effusion, which is an abnormal accumulation of fluid in the pleural space surrounding the lungs, as supported by the most recent evidence 1. This occurs through several mechanisms, including direct tumor invasion through the diaphragm, obstruction of lymphatic drainage, or production of proteins that increase vascular permeability, allowing fluid to leak into the pleural space. Some key points to consider:
- HCC often develops in patients with cirrhosis, which itself can cause pleural effusion through decreased oncotic pressure from hypoalbuminemia or portal hypertension 1.
- The pleural effusion associated with HCC is typically right-sided due to the liver's anatomical position, and it may be bloody (hemorrhagic) or contain high protein levels.
- Patients with HCC-related pleural effusion often experience symptoms like shortness of breath, chest pain, and dry cough.
- Management typically involves treating the underlying HCC while providing symptomatic relief through thoracentesis or pleurodesis if the effusion is recurrent or causing significant respiratory compromise, as discussed in 2 and 3. It's essential to prioritize the treatment of the underlying HCC and provide symptomatic relief to improve the patient's quality of life, as the presence of malignant pleural effusion indicates advanced disease and poor survival 2.