Malignant pleural effusion affects more than 150 000 patients per year in the United States, and its prevalence continues to increase.1 A malignant pleural effusion usually signifies advanced metastatic disease and is associated with a poor prognosis with median survival between 3 and 12 months, depending on the primary site.2 Lung cancer accounts for more than a third of cases of malignant effusion, with a life expectancy of less than 4 months.3,4