A 55-year-old woman with a 1-year history of nonsmall cell lung cancer underwent planar bone imaging with nonvisualization of the right kidney. The kidneys were in their usual location as seen on a bone scan taken 13 months earlier. Subsequent computed tomography identified inferior and anterior displacement of the right kidney by a large right subpulmonic effusion and a pleural-parenchymal abnormality that displaced the diaphragm and liver inferiorly.