Talc pleurodesis is commonly used for the treatment of pleural effusions and recurrent spontaneous pneumothoraces. Following this procedure, pleural abnormalities are common and include pleural thickening and loculated effusions, as well as nodules and masses. Animal studies have shown that, even with uniform distribution of talc during thoracotomy, talc has a tendency to accumulate in focal collections and may lead to local abnormalities. In one study of patients with LAM who underwent talc sclerosis, 76% of patients had pleural abnormalities, with solid pleural masses or nodules found in 14% of patients. Focal abnormalities up to 3.7 cm in size have been reported and are frequently enhanced on contrast CT scans. Nodules or masses related to talc sclerosis are found most commonly in the posterior caudal aspect of the thorax, often in paramediastinal or paravertebral areas, as demonstrated in our patient. They can be extensive and extend to the apical regions. Characteristically, talc-associated pleural masses have high attenuation. This feature can be used to distinguish them from masses occurring after pleurodesis with other agents. Talcomas can continue to show growth for years following pleurodesis, which often raises concern for the development of cancer, as was the case in our patient.