Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient with known metastatic lung cancer . Since the prior exam , the patient has been extubated . Minimal apical left pneumothorax is unchanged . Left lung collapse and right lung multiple metastases unchanged . Right mild - to - moderate pleural effusion has increased .
    OUTPUT:
    
Patient with metastatic lung cancer . Right mild - to - moderate pleural effusion has worsened . Minimal residual right pneumothorax is unchanged .