Pubic bone metastasis as first manifestation of lung cancer

Lung cancer is a severe disease often diagnosed a late stage when surgical resection is no longer possible because of local advancement or distant metastasis.1 Bone metastases from lung cancer may occur early in the clinical course and are usually discovered with severe pain.2-4 The spine and ribs are often the earliest sites of bone metastases, whereas the skull, femur, humerus, and scapula are involved later.5 Pubic bone metastasis as the initial manifestation of lung cancer is very rare. We report a case of particular interest because of unusual bone metastatic site and the relatively slow progression of the neoplasm.