Angiofibroma is a benign mesenchymal tumor. It’s clinical presentation is nonspecific and similar to other vulvar tumors. Angiofibroma has good prognosis,despite some risk of recurrence.We present a 44-year-old woman with a bulky left vulvar lesion.

Chilaiditi's sign describes the incidental radiographic finding of the bowel positioned between the right diaphragm and the liver. This is a rare condition typically mistaken for pneumoperitoneum, which may lead to unnecessary investigations or surgical procedures. CT scan can confirm the diagnosis.

Introduction Pleural effusions can be secondary to a myriad of conditions. Rarely can it be due to hypothyroidism as well. We present a case of massive pleural effusion resulting from hypothyroidism. Case A 75-year-old male with a history of liver cirrhosis, hypothyroidism and medication non-adherence was brought into the emergency department (ED) with shortness of breath and altered mental status. Physical exam and chest imaging was consistent with right sided pleural effusion. Effusion was exudative in nature. The hospitalization was complicated by multiple recurrences despite thoracentesis and pleurodesis. Labs revealed hypothyroidism and finally the patient was started on hormone replacement resulting in resolution of the effusion. Discussion Pleural effusion is a rare manifestation of hypothyroidism which is thought to be mediated by vascular endothelial factor. Both exudative and transudative patterns can be seen on pleural fluid analysis. Mainstay of treatment is hormonal replacement. Conclusion The clinicians need to be cognizant of the rare etiologies of pleural effusion. Due work-up should be done depending on patient presentation for a timely diagnosis and management.