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An unusual chest wall swelling mimicking tumorous growth

Chest wall swelling with underlying lung involvement is a rare phenomenon and it poses certain diagnostic challenges as well. It has to be differentiated from other swellings with different underlying etiology. We present a case where a 60-year-old man presented with a progressive chest wall swelling over right sterno-clavicular joint abutting the manubrium sterni. The origin of the swelling resulted from a leak of air from a tense tubercular cavity in the lung parenchyma that was diagnosed with the help of a contrast-enhanced computerized tomography thorax. The case was managed conservatively with antitubercular therapy and evacuation of air from the chest wall swelling by a nasogastric tube.