Sub cuteneous swelling as the first clinical manifestation of small cell carcinoma of lung

Subcutaneous swelling as first clinical presentation of small cell lung carcinoma is uncommon and rarely reported in literature. This case highlights a rare presentation in which subcutaneous swelling was the first clinical manifestation of a small cell carcinoma of lung which also had metastasis to rib bone, muscle and pleural involvement as pleural effusion. We describe the case of a 64-year-old male patient who presented with dyspnea, pleuritic pain, loss of weight and nodule on his anterior chest, back and left arm suspicious of lipoma. Biopsies revealed small cell carcinoma of lung. This case demonstrates the meticulous work up of subcutaneous swelling in the clinical scenario of breathlessness, chest pain and loss of weight.