Primary sclerosing epithelioid fibrosarcoma of the pleura

The thoracic surgery team requested a chest CT scan, which revealed a lung mass and a pleural lesion. Pleural and lung biopsies were therefore performed. Pathological findings were suggestive of sarcoma or sarcomatoid mesothelioma. Further investigation included CT scans of the chest, abdomen, and pelvis, as well as magnetic resonance imaging of the chest. Chest CT and magnetic resonance imaging findings included extensive pleural effusion with anterior septation; contrast-enhanced tissue formations in the parietal pleura, the largest of which was 8.5 cm × 2.0 cm and located posterior to the basal segments on the left; left lung volume loss; and intraparenchymal nodules scattered throughout the left lung parenchyma, the largest of which was 1.7 cm.