The treatment of malignancy-associated chylous pleural effusion and ascites, especially in the palliative setting, represents a major therapeutic challenge. Our patient, a case of metastatic lung cancer, was suffering from high-output, non-resolving, malignancy-related chylothorax. We found that subcutaneous octreotide in combination with fasting and total parenteral nutrition, followed later by institution of low-fat diet, resulted in its resolution. We suggest that it is a reasonable approach associated with minimal morbidity in what is otherwise a challenging clinical condition.
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