Bilateral chylothorax due to gastric carcinoma and metastatic prostate carcinoma: Case reports

Abstract

Gastric carcinoma and metastatic prostate carcinoma have rarely been reported as the cause of bilateral chylothorax. Although chylothorax is a potentially life threatening disease, successful results can be achieved with the urgent and optimal palliative management. Case 1: A 39 year-old man presented with 8 weeks of pleuritic chest pain, cough, dyspnea together with mild bilateral edema of the lower extremities. The milky white effusion contained 288 mg/dl triglycerides and 65 mg/dl cholesterol. Lymph node extirpation was diagnostic and revealed metastatic lymph node of gastric signet-ring cell adenocarcinoma. Patient was discharged after 10 days of hospitalizations and died 22th day. Case 2:A 73 year-old man has an history of prostate carcinoma and metastatic lesions in vertebrae admitted to our hospital. He is still alive. Bilateral pleural effusions have been identified as chylous exudates in both cases which is rarely seen. (Figure) Depleted function of respiratory, nutritional, and immunological status is important for the clinical course of patients with chylothorax. An appropriate low-fat diet was initiated and bilateral intercostal tube insertion and drainage was performed. No evidence-based guidelines to address optimal management of this disease. We aimed to discuss here rarely seen presentation as a bilateral chylothorax related with the gastric and prostatic carcinoma treated with optimal conservative treatments.