Pleural tumours develop in the pleural space between the lungs and chest wall, where lubricating pleural fluid is normally found. These tumours are almost always metastatic and carry a poor prognosis, with one notable exception: localised fibrous tumours of the pleura (LFTP), where only one in eight cases is cancerous and surgical outcomes are generally favourable.
Metastatic pleural tumours typically represent secondary cancers, arising when cancer cells spread from elsewhere in the body (usually the lungs) via bloodstream, lymphatic system, or direct contact. This affects approximately one in 2,000 cancer patients. The tumors commonly cause pleural effusion—abnormal fluid accumulation in the chest cavity—which provides valuable diagnostic information.
Symptoms include shortness of breath during activity, chest pain, general discomfort, cough, and unintended weight loss. LFTPs may remain asymptomatic and are often discovered incidentally on chest X-rays.
Primary causes include complications from mesothelioma related to asbestos exposure, though other cancers can metastasise to the pleural space. LFTP causes remain largely unknown.
Treatment for LFTPs involves surgical removal with good prognosis. Metastatic pleural tumours typically cannot be surgically removed, so treatment focuses on the underlying cancer using chemotherapy and radiation therapy.
