Pulmonary Adenocarcinoma Presenting as Paraspinal MuscleMetastatic Mass

A 39-year-old male presented with a painful paraspinal mass, which had been present for several weeks. The mass had previouslybeen treated with oral sulfamethoxazole and trimethoprim DS, as the patient reported a history of“boils,”with no improvement inhis pain or size of the mass. No further diagnostic workup was pursued until he was admitted with intractable pain. Eventual biopsyrevealed adenocarcinoma, likely of pulmonary origin. This report, as well as other incoming cases, highlights this rare phenomenonof muscular metastases as the sole presentation of a distant primary malignancy.