Chemical Pleurodesis in the Treatment of Recurrent Chylothorax Due to Renal Cell Carcinoma

Chylothorax is defined as a pleural effusion with triglyceride levels greater than 110 mg/dL and/or chylomicrons present in the pleural fluid. A chylothorax may be classified as traumatic or nontraumatic, with malignancy being the most common cause of atraumatic chylothoraces. Herein, we present the case of a 63-year-old woman with a past medical history of a mediastinal teratoma and stage III colon adenocarcinoma who presented to the emergency room with new-onset shortness of breath. A week prior to presentation, she was diagnosed with metastatic renal cell carcinoma after a retrocrural lymph node was biopsied. In the emergency department, a chest X-ray revealed a large right-sided pleural effusion, which was later diagnosed as a chylothorax based on pleural fluid analysis. Thoracentesis was performed and the patient was sent home. Three days later, the patient returned after experiencing palpitations and shortness of breath. The patient was diagnosed with recurrent chylothorax after a repeat chest X-ray and thoracentesis. The patient was ultimately treated with chemical pleurodesis. To the best of our knowledge, this case is the only reported chylothorax due to renal cell carcinoma metastasis reported in the literature. It describes the presentation and subsequent successful treatment of this rare condition with chemical pleurodesis.