Unmasking Metastatic Squa...

A 56-year-old female presented to the chest clinic with a chief complaint (c/o) of cough productive of serous sputum, chest pain, and significant weight loss. She also reported a history of dog exposure. A chest X-ray (CXR) was performed. Echinococcus-specific IgG testing was advised, which was negative. Routine blood tests were within normal limits (WNL) except for an elevated CA-125 level. Chest CT (CECT) revealed bilateral multiple diffuse cystic solitary pulmonary nodules (SOLs). PET-CT scan showed metabolically active lesions in both lungs and a lytic lesion in the sacral ala. CT-guided fine-needle aspiration (FNAC) and Tru-Cut biopsy of a lung lesion diagnosed moderately differentiated squamous cell carcinoma of unknown primary origin.