Forearm metastases as unsuspected first manifestations of lung adenocarcinoma

Abstract

An 83-year-old male who was a former smoker had pain on the left forearm accompanied with progressive swallowing in the last four to five months. Imaging studies revealed a cystic necrotic mass on the flexor digitorum superficialis muscle (biopsy: striated muscle tissue infiltrated by an adenocarcinoma). A whole-body computerized tomography (CT) scan demonstrates the presence of two lung masses that were suspicious of malignancy. Diagnosed as having stage IV lung adenocarcinoma (cT4NxM1b, IASLC TNM 8 th ), he received chemotherapy with a carboplatin/pemetrexed-based regimen and local palliative radiation for the control of arm pain.