Acute Hydrothorax Due to HCC Involving Diaphragm during Peritoneal Dialysis

Ahn, Yong Sung; Kang, Jin; Song, Moo Gon; Park, Ki Tae; Park, Tae Ik; Ahn, Seung Jae; Song, Sang Heon; Lee, Dong Won; Lee, Soo Bong; Kwak, Ihm Soo

Abstract

Massive hydrothorax is uncommon but well recognized complication of peritoneal dialysis. Possible mechanisms include a disorder of lymphatic drainage, pleuro-peritoneal pressure gradient, and congenital diaphragmatic defects. Hydrothorax in a CAPD patient caused by infiltrative disease or malignancy is very rare. Recently, two cases of hydrothorax in CAPD patients caused by systemic amyloidosis involving diaphragm were reported. However, no case of pleuro-peritoneal communication secondary to HCC infiltrating diaphragm was reported. This case was of a hydrothorax due to HCC in a CAPD patient. We performed video-assited thoracoscopic resection of diaphragmatic mass, diaphragmatic repair and thoracoscopic talc pleurodesis. This case showed that malignancy might be considered as a cause of a hydrothorax in a CAPD patient.