An Unanticipated Diagnosis in a Child with Blunt Chest Trauma

A 13-year-old girl presented 20 days after blunt chest trauma with persistent hemopneumothorax despite intercostal drainage (ICD). Imaging revealed a large peripherally enhancing lesion in the right chest with a third rib fracture, raising suspicion of retained hemothorax. She underwent thoracotomy and decortication, and histopathology identified a malignant mesenchymal neoplasm with pulmonary metastasis. This case highlights the importance of considering malignancy in trauma patients whose clinical course deviates from expectations and demonstrates the diagnostic value of early advanced imaging and surgical exploration.