Painful shoulder and scapula as initial presentation of advanced lung adenocarcinoma.

Lung adenocarcinoma is a common cancer; even though it has a strong association with previous smoking, there has been described nonsmokers-related cases. Symptoms varies from asymptomatic to hemoptysis or pleural effusion. We describe a case of a patient who presented with painful scapula as primary manifestation of advanced pulmonary malignancy.