Lung Adenocarcinoma with Miliary Metastases and Left Femur Pathologic Fracture: an Unusual Case Mimicking Disseminated Tuberculosis

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7


  1. 1.

    Austin JH, Garg K, Aberle D, et al. Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology. 2013; 266(1): 62-71.

    Article  PubMed  Google Scholar 

  2. 2.

    Battafarano RJ, Meyers BF, Guthrie TJ, Cooper JD, Patterson GA. Surgical resection of multifocal non-small cell lung cancer is associated with prolonged survival. The Annals of Thoracic Surgery. 2002; 74(4): 988-93. discussion 93-4.

    Article  PubMed  Google Scholar 

  3. 3.

    Boitsios G, Bankier AA, Eisenberg RL. Diffuse pulmonary nodules. AJR American Journal of Roentgenology. 2010; 194(5): W354-66.

    Article  PubMed  Google Scholar 

  4. 4.

    Burrill J, Williams CJ, Bain G, Conder G, Hine AL, Misra RR. Tuberculosis: a radiologic review. Radiographics. 2007; 27(5): 1255-73.

    Article  PubMed  Google Scholar 

  5. 5.

    Chun-Yi L, Yiing-Feng H, Hua-Tzu H, Chang-Sheng L. Lung cancer with solitary bone metastasis in the radius. Clinical Nuclear Medicine. 2009; 34(10): 684-5.

    Article  PubMed  Google Scholar 

  6. 6.

    Davidson PT, Horowitz I. Skeletal tuberculosis. A review with patient presentations and discussion. The American Journal of Medicine. 1970; 48(1): 77-84.

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Deutsch A, Resnick D. Eccentric cortical metastases to the skeleton from bronchogenic carcinoma. Radiology. 1980; 137(1 Pt 1): 49-52.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Furqan M, Butler J. Miliary pattern on chest radiography: TB or not TB? Mayo Clinic Proceedings. 2010; 85(2): 108.

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Galmarini CM, Kertesz A, Oliva R, Porta J, Galmarini FC. Metastasis of bronchogenic carcinoma to the thumb. Medical Oncology. 1998; 15(4): 282-5.

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Guangsheng P, Weijiao Y, Gang L, Xiaoli W, Lingxia L, Yimin M. Miliary lung adenocarcinoma: a case report. International Journal of Clinical and Experimental Pathology. 2016; 9(2): 2563-6.

    Google Scholar 

  11. 11.

    Gurrieri L, Longhi A, Braghetti A. Lung cancer presenting as a metastasis to the tibial bones: a case report. Tumori. 2015; 101(1): e18-20.

    PubMed  Google Scholar 

  12. 12.

    Jayaram Subhashchandra B, Ismailkhan M, Chikkaveeraiah Shashidhar K, Gopalakrishna Narahari M. A rare case of non-small cell carcinoma of lung presenting as miliary mottling. Iran J Med Sci. 2013; 38(1): 65-8.

    PubMed  PubMed Central  Google Scholar 

  13. 13.

    Kaila R, Malhi AM, Mahmood B, Saifuddin A. The incidence of multiple level noncontiguous vertebral tuberculosis detected using whole spine MRI. Journal of Spinal Disorders & Techniques. 2007; 20(1): 78-81.

    Article  Google Scholar 

  14. 14.

    Laack E, Simon R, Regier M, et al. Miliary never-smoking adenocarcinoma of the lung: strong association with epidermal growth factor receptor exon 19 deletion. Journal of Thoracic Oncology. 2011; 6(1): 199-202.

    Article  PubMed  Google Scholar 

  15. 15.

    Mir NA, Baba AN, Ahmad SM, Paljor SD, Bhat JA. Big toe metastases as first clinical sign of occult bronchogenic carcinoma. Journal of the College of Physicians and Surgeons–Pakistan. 2010; 20(10): 699-700.

    PubMed  Google Scholar 

  16. 16.

    Nagata M, Kudoh S, Mitsuoka S, et al. Skeletal-related events in advanced lung adenocarcinoma patients evaluated EGFR mutations. Osaka City Medical Journal. 2013; 59(1): 45-52.

    PubMed  Google Scholar 

  17. 17.

    Park YK, Park JS, Han CS. Tuberculosis manifesting as multifocal lytic cortical lesions in the femur. Skeletal Radiology. 2004; 33(4): 244-7.

    Article  PubMed  Google Scholar 

  18. 18.

    Pauzner R, Istomin V, Segal-Lieberman G, Matetzky S, Farfel Z. Bilateral patellar metastases as the clinical presentation of bronchogenic adenocarcinoma. The Journal of Rheumatology. 1996; 23(5): 939-41.

    CAS  PubMed  Google Scholar 

  19. 19.

    Roberts PF, Straznicka M, Lara PN, et al. Resection of multifocal non-small cell lung cancer when the bronchioloalveolar subtype is involved. The Journal of Thoracic and Cardiovascular Surgery. 2003; 126(5): 1597-602.

    Article  PubMed  Google Scholar 

  20. 20.

    Shih WJ, Magoun S, Lahar B, Stipp V, Gross K. An unusual case of a tibial metastasis as the clinical presentation of bronchogenic adenocarcinoma. Journal of Nuclear Medicine Technology. 1998; 26(2): 91-3.

    CAS  PubMed  Google Scholar 

  21. 21.

    Singh C, Gupta M, Singh J, Ali A. Isolated Calcaneal Metastasis: An Unusual Presentation of Lung Carcinoma as Heel Pain. Clinical Nuclear Medicine. 2016; 41(3): 214-6.

    Article  PubMed  Google Scholar 

  22. 22.

    Travis WD, Garg K, Franklin WA, et al. Bronchioloalveolar carcinoma and lung adenocarcinoma: the clinical importance and research relevance of the 2004 World Health Organization pathologic criteria. Journal of Thoracic Oncology. 2006; 1(9 Suppl): S13-9.

    Article  PubMed  Google Scholar 

  23. 23.

    Zamzuri Z, Adham SY, Shukrimi A, Azril MA, Amran RB. Metastatic Adenocarcinoma of the Lung Mimicking Spinal Tuberculosis. Internal Medicine Journal Malaysia. 2011; 10(1): 41-4.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to George R. Matcuk Jr. MD.

Ethics declarations

Conflict of Interest

Nasim Khadem, MD; Cristina Costales, MD; Eric A. White, MD; Dakshesh B. Patel, MD; Anderanik Tomasian, MD; and George R. Matcuk, Jr., MD, have declared that they have no conflict of interest.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent


Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.


(PDF 1224 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Khadem, N., Costales, C., White, E.A. et al. Lung Adenocarcinoma with Miliary Metastases and Left Femur Pathologic Fracture: an Unusual Case Mimicking Disseminated Tuberculosis. HSS Jrnl 13, 201–206 (2017).

Download citation


  • lung adenocarcinoma
  • miliary metastases
  • pathologic fracture
  • mimics tuberculosis