Background: Inflammatory pseudo tumor, a rare non-neoplastic lesion, commonly presents as slow growing solid lesion in the lung, but many extra-pulmonary locations have been described.
Case characteristics: A 4-year-old girl who presented with respiratory distress due to massive pleural effusion. Computed tomography revealed large hypodense non-enhancing lesion in the left hemi thorax. Surgical exploration revealed large semisolid pleural collection filled with gelatinous material with normal underlying lung.
Outcome: Histopathology revealed spindle shaped cells with abundant myxoid stroma. Child recovered after surgery and was asymptomatic at 5 years follow-up.
Message: Primary pleural inflammatory pseudotumor may be a rare cause of pleural effusion in a child.