Management of Malignant Pleural Effusion - Indwelling Pleural Catheter or Talc Pleurodesis

Inclusion Criteria: 1. Patients with recurrent symptomatic pleural effusion, the diagnosis was obtained by : - positive cytology for malignant cells in the fluid. * patients well known for malignancy, with exudative pleural effusion with no alternative diagnosis. * pleural biopsy - surgically obtained - with diagnosis of pleural malignancy * microscopic intraoperative findings suggestive of pleural malignancy. 2. Patients who underwent prior to involvement in the study, draining of the pleural fluid with symptomatic improvement. 3. Patients with rate of fluid accumulation less than 30 days. 4. Patient who signed informed consent about being involved in the study. Exclusion Criteria: 1. Patients under the age of 18 years. 2. Female patients who are Pregnant or nursing. 3. Patients with rate of pleural effusion accumulation is more than 30 days. 4. Patients who didn't show clinical improvement post proper draining of the fluid 5. Patients who are hemodynamically or respiratory unstable. 6. Patients with Empyema. 7. Patients who are non functioning/ not active according to the Performance status. 8. The type of malignancy which cause the malignant pleural effusion is Lymphoma. 9. Patient who underwent pneumonectomy at the side of the fluid. 10. previous pleurodesis at the side of pleural effusion. 11. Chylothorax in the initial pleural tapping.