A 76-year-old woman with chronic tuberculous empyema presented with bloody sputa and anorexia in April 2005. Chest X-ray and CT scan showed no obvious change compared with previous films. She complained of a left chest pain in June 2005, and chest CT scan showed a tumor shadow enhanced heterogeneously on the left chest wall and chronic empyema. After admission, the chest wall mass grew rapidly. Neither CT- nor sonographically guided biopsy yielded a definitive diagnosis. Dynamic MRI showed a high signal intensity unlike hematoma. She died of respiratory failure 2 months after the onset of her chest pain. Autopsy revealed angiosarcoma. We should always keep in mind the early diagnosis of malignant tumor and tuberculosis in patients presenting with a chest wall mass and constitutional symptoms during follow-up of chronic tuberculous empyema.
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