A 43-year-old female with neurofibromatosis type 1 (NF1) presented with gradual onset of shortness of breath and back pain for several months. She also noticed swelling over the right aspect of her anterior chest wall (Fig. 1a). She had no history of fever, cough, sputum, trauma, or weight-bearing. Physical examination revealed multiple nodules and two larger masses over the trunk, decreased right breath sounds, and dullness on percussion. Computed tomography (CT) findings are shown in Fig. 1b and c.