Massive benign or malignant thoracic tumors in children may arise from
the chest wall, pleura, lung parenchyma, or mediastinum and may be pr
imary or secondary. On initial chest radiographs, these masses usually
appear as an opaque hemithorax or an obvious large opaque mass. If th
e site of origin of the intrathoracic tumor can be determined, the dif
ferential diagnosis may be based on the location of the tumor, the age
of the patient, and distinguishing imaging features. The purpose of t
his essay is to illustrate imaging findings of large intrathoracic mas
ses that cause an opaque hemithorax on initial chest radiographs, Ches
t wall masses that do not grow primarily intrathoracically are not inc
luded in this discussion.