[A Migrating Pulmonary Mass: a Rare Case of Thoracolithiasis]

We report on an 70-year old male patient with progressive dyspnoea. For further differential diagnosis he underwent a CT thorax in the pulmonary arterial phase. This revealed a solid, pleural round lesion. The lesion was located paravertebrally in the area of the distal aortic arch. Initially the dignity of the round lesion was undetermined. A subsequent examination conducted three months later, utilising HRCT, revealed no alterations in the dimensions or configuration of the mass. A change in position was observed. In this case of idiopathic phrenic nerve paralysis with diaphragmatic atrophy, diaphragmatic elevation and chronic progressive exertional dyspnoea, the surgical intervention involved a diaphragmoplasty and the surgical removal of the voluminous thoracolith by means of a muscle-sparing limited lateral thoracotomy. The diagnosis of a thoracolith was confirmed on the basis of morphologic criteria and a change in position.