title: [Muscle metastasis revealing bronchial adenocarcinoma].
abstract: BACKGROUND
  The diagnosis of nonsmall cell lung cancer is made at a metastatic stage in 25% of cases. The most frequent sites are the lung, liver, bone, the adrenal glands and the central nervous system. Skeletal muscle metastases are uncommon and are rarely the first manifestation of a neoplastic process.
  
  
  METHODS
  We report the case of 55 years old man presenting with a hard painless swelling of the left arm. A scan guided biopsy revealed infiltration of the muscle by a thyroid transcription factor 1 (TTF1) positive adenocarcinoma. A CT scan of the chest showed a partially necrotic tissue mass with moderate uptake of contrast. The patient was treated by chemotherapy with gemcitabine and carboplatine. The progress was unfavourable with the appearance of a second muscular metastasis in the thigh and the patient died 3 months after diagnosis.
  
  
  CONCLUSIONS
  Skeletal muscle metastases are rarely described in lung cancer and they are an exceptional presentation of the tumour. Their symptoms can be misleading and delay diagnosis.
authors.affiliation: Service de Pneumo-Allergologie, CHU Hédi Chaker, 3029 Sfax, Tunisie. wajdi.ketata@yahoo.fr
authors.forename: W
authors.initials: W
authors.lastname: Ketata
authors.forename: W
authors.initials: W
authors.lastname: Feki
authors.forename: S
authors.initials: S
authors.lastname: Msaad
authors.forename: I
authors.initials: I
authors.lastname: Yangui
authors.forename: A
authors.initials: A
authors.lastname: Ayoub
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001132:Arm; D001706:Biopsy; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D018482:Muscle, Skeletal / Q000473:pathology; D009367:Neoplasm Staging; D010166:Palliative Care; D014057:Tomography, X-Ray Computed