A complete hemithorax white-out is apparent on the left with significant mediastinal shift to the right. Findings are in line with a very large unilateral hydrothorax (considering the pattern most likely due to the known metastatic primary malignancy) with resultant complete atelectasis on the left.
These findings are in good agreement with the clinical picture, symptoms, and fit the results of the physical exam as well. The gross abnormality is therefore prone to satisfy the reader (satisfaction of search error), which unfortunately reduces the chance of detecting another significant "edge-of-image" pathology, a hitherto unknown, partially displayed irregular fracture of the right proximal humerus with adjacent hazy callus formation (see key image).
The reader therefore requested additional radiographs of the right shoulder.