Metastatic squamous cell carcinoma of the lung mimicking multiple bone abscesses

Squamous cell carcinoma of the lung is known to metastasize to the bones, but a presentation similar to bone abscess is rare. We encountered a case with bone metastases that mimicked bone abscess, which delayed the diagnosis of squamous cell lung carcinoma. A 67-year-old man presented with a left upper lung infiltrate and lytic lesions on the left first rib and right fifth rib. In consideration of a possible infectious process, cultures of the aspirate from the right fifth rib lesion and blood were taken; however, results were non-specific. Thereafter, bronchoscopic biopsy of the left upper lung nodule and ultrasound-guided biopsy of the right fifth rib lesion yielded a diagnosis of squamous cell lung carcinoma with bone metastases. Metastatic squamous cell lung carcinoma may have imaging characteristics of bone abscess and should be considered in the differential diagnosis of such lesions.