A 29-year-old woman with an unremarkable medical history was referred to our emergency department with complaints of shortness of breath and right-sided chest pain on inspiration since three weeks and three kilograms of weight loss in the last six weeks. She did not smoke and used neither drugs nor medication. Physical examination revealed a fixed elastic swelling with a diameter of 10 cm of the right thigh. There were no enlarged lymph nodes and examination of the lungs and the breasts revealed no abnormalities. Pulse oximetry showed an saturation of 99% on room air. Laboratory results revealed: haemoglobin 6.9 mmol/l, leucocytes 10.8 x 109/l, erythrocyte sedimentation rate 97 mm/h lactate dehydrogenase 299 U/l, gamma-glutamyltransferase 176 U/l and normal transaminases. A chest X-ray demonstrated multiple large round masses in both lungs (figure 1A and 1B).