Herein, we report a case of lung cancer presented initially as hydro-pneumothorax and has undergone intercostal tube drainage, received repeated courses of antibiotics and even antitubercular drugs without any improvement. Without a confirmatory diagnosis, patient was referred to our institution. Based on initial and follow-up chest X-rays, it was suspected to be either an encysted empyema or lung abscess. But on computed tomography (CT) thorax the thick walled cavitary mass was seen, and CT guided fine- needle aspiration cytology proved the diagnosis. Thus, it′s a rare presentation of lung cancer as hydro-pneumothorax.
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