Abstract: Objective To analysis the reason why patients with shoulder and back pain caused by pulmonary cancer osseous metastasis were misdiagnosed.Methods A patient of pulmonary cancer with osseous metastasis who was misdiagnosed as herniation of cervical disc,shoulder and back chronic lesion were analysed and reviewed with the literature.Results The involved vertebral bodies were osteolysis or wedging,the tumor encroach in cortical bone or soft tissue could result in shoulder and back pain.Conclusion A complete history and physical examine,systemic differential diagnosis,proper radiographic examination can decrease the incidence of misdiagnosis.

Key words: pulmonary cancer, misdiagnosis, pain, herniation of cervical disc