Case 171

Male patient, 63 years old, with squamous cell carcinoma at the base of the tongue that partially occludes the airway, is admitted for elective tracheostomy. During the procedure, the puncture of the right central vein was performed. The patient evolved with desaturation, breathlessness and chest pain on the right. On physical examination, he was normotensive, with labored breathing and decreased respiratory sounds in the right hemithorax. Chest radiograph (Figure 1) has been requested.

Analyzing the clinical history and the radiography, which is most likely diagnosis and the proper work up?

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