A 44-year-old female, a farmer by occupation, presented with a c/o cough with yellowish expectoration and low-grade fever since 4 months, dyspnea MMRC II and diffuse chest pain since 15 days. She had no past history. On examination her vitals were stable. On Respiratory system examination, breath sounds were reduced in left basal areas. On  investigation: Hemogram, blood sugar, Urine routine, LFT, and RFT were within normal range. HbA1C was normal ruling out diabetes.

HIV and HBsAg status were Non-reactive. Sputum for AFB was negative. CXR was suggestive of left-sided pleural effusion. CT thorax was suggestive of ill-defined, heterogeneous mass lesion  involving  left pleura, pericardium, chest wall and cardiac apex, with filling defect in the left ventricle and bilateral pleural effusion (left > right) with hypodense lesion in liver, suggestive of neoplastic etiology. Around 700 ml…