Thoracoscopic Management of Pleural Effusions in Kaposi's Sarcom
Kaposi's sarcoma (KS) is one of the most common causes of pleural effusion in patients with acquired immunodeficiency syndrome (AIDS). Pleural effusions due to KS carry a high morbidity and mortality. Their treatment is difficult, and they respond poorly to chemical pleurodesis. Even systemic chemotherapy against KS has little effect on the pleural effusions. Commonly, repeated therapeutic thoracentesis or chest tube drainage is required. We present a case of advanced KS with bilateral pleural effusions. We believe this is the first reported case in which medical thoracoscopy with talc pleurodesis has been shown to achieve adequate control of the effusions.

Pleural effusions due to KS are common in patients with AIDS. These pleural effusions are difficult to treat and carry a high morbidity and mortality. Chemical pleurodesis and systemic chemotherapy commonly fail to control these effusions, which tend to be bilateral. These patients have progressive dyspnea and usually require repeated therapeutic thoracentesis. Eventually, chest tube drainage may be required. Treatment of the effusions improves quality of life. We present a case of advanced KS with bilateral pleural effusions. For treatment we used medical thoracoscopy with talc pleurodesis, successfully controlling the effusions. This appears to be the first reported case in which this method of pleurodesis was used in KS with good response.