A 60-year-old Australian woman presented to a UK hospital with progressive breathlessness over a two-week period. Clinical examination and chest radiograph revealed a large right-sided pleural effusion. A chest drain was inserted and the patient was referred to respiratory medicine.Past medical history included ovarian carcinoma treated with chemotherapy in Australia earlier in the year. She had been admitted to another UK hospital a few weeks earlier, again with a right-sided pleural effusion. This had been treated by simple aspiration without drain insertion and a cytology specimen taken at that time was suspicious for a poorly differentiated carcinoma. The sample was not sufficient to confirm metastasis from the ovarian cancer, or to exclude a second primary.
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