Pulmonary Adenocarcinoma Presenting as Paraspinal Muscle Metastatic Mass

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