We present the case of a 48-years old man, smoker, with cough, hemoptysis and dyspnea. The chest x-ray in the context of showed a broad, medially concave, kidney shaped opacity at the left hemithorax. The patient received diuretics and three days later the density disappeared. The final diagnosis was left cardiac failure (phantom tumor) in the context of aortic valve stenosis. Although the localization of pleural fluid at the left is unusual we should keep in mind this possibility when history or clinical examimation support it. The patient may avoid inappropriate or invasive diagnostic procedures such as biopsy or surgery. Pneumon 2001, 14 (1): 81-85