International Journal of Clinical & Medical Images

A 31-year-old man was referred due to dry cough for 6 months. He had no constitutional symptoms or dyspnea. He had a history of Holt-Oram syndrome, with regular follow-up by cardiology. He had never smoked. On physical examination he had diminished breath sounds on the left hemithorax, with no other remarkable findings. Computed tomography scan (Panel A) revealed a large heterogeneous mass on the left hemithorax. Magnetic resonance imaging (Panel B) confirmed a well-defined mass, with heterogeneous contrast uptake and multiple cystic areas, and associated pleural effusion. He was submitted to an ultrasound-guided transthoracic needle biopsy which revealed a malignant mesenchymal neoplasm compatible with an extraosseous Ewing sarcoma. Positron-emission tomography showed no further disease sites.