What happened, in summary

A 47-year-old woman developed worsening right-thigh pain, swelling, and a rapidly enlarging mass. Imaging initially raised concern for a primary soft-tissue sarcoma, but biopsy showed metastatic adenocarcinoma with features pointing to a lung origin. Further imaging identified a lung primary together with additional lesions in both iliac bones, several vertebrae, both lungs, and the large thigh mass, establishing Stage IV lung adenocarcinoma. A multidisciplinary team chose a palliative systemic approach with gefitinib, zoledronic acid, and chemotherapy. Over the following months, her pain improved substantially even without analgesics, she regained the weight she had lost, and the thigh swelling and mass decreased. At 9 months, imaging showed a partial response in the pulmonary lesion. She remained unable to walk, but the reduction in pain and tumor burden showed meaningful treatment benefit.