A 33-year-old African-American woman presented with left-sided chest pain for 2 months before admission. Physical examination revealed no breath sound in the left chest and CT scan of the chest showed total obliteration of the left pleural cavity. The patient also had hypertension and elevated urinary metanephrines, leading to a tentative diagnosis of a catecholamine-secreting paraganglioma. MRI revealed a large, heterogeneous soft tissue mass that occupied the entire left chest cavity, causing displacement of the heart and mediastinal structures to the right. Through a left thoracotomy incision, a tumour weighing 2790 g was removed along with a small portion of adherent lung. The tumour was positive for CD34 but negative for S-100, keratin, desmin and progesterone-receptor, which is consistent with pathological diagnosis of a solitary fibrous tumour of the pleura. The patient remains symptom free 4 years after the operation.
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