Limping man--unusual presentation of lung carcinoma

The authors report a case of a 61-year-old male smoker with primary adenocarcinoma of the lung with brain metastases. He presented with a 2 month history of a gradually worsening unilateral limp with no other local or systemic symptoms. History and examination findings suggested an upper motor neuron lesion but failed to indicate the level of the pathology. On further investigation, a mass was found in the upper lobe of the left lung and two ring-enhancing brain lesions. With surgical intervention ruled out, he was commenced on high dose dexamethasone and is currently undergoing palliative whole brain radiotherapy.