A 44-year-old man presented to our ED with progressive shortness of breath and left-sided pleuritic chest pain. His history was remarkable for alcohol and tobacco abuse. On examination, his vital signs were stable except for sinus tachycardia (119 beats/min). Laboratory values for cardiac markers were within normal limits, and chest roentgenogram was notable for a wedge-shaped infiltrate (Fig 1). Acute pulmonary embolism (PE) was suspected, and CT pulmonary angiography (CTPA) was performed. The CTPA showed multiple PEs in segmental branches and wedge-shaped infarcts in the bilateral lower lobes (Fig 2). In addition, a mass was noted near the periphery of the right hepatic lobe, suspicious for a malignancy (Fig 3). The patient was treated for acute PE with heparin and transitioned to warfarin. In addition, investigations were undertaken to further characterize the liver mass. Biopsy of the liver mass was deferred because of the immediate need for anticoagulation and was scheduled to be obtained as an outpatient. The patient was discharged with improvement in his symptoms.