Carsten Nieder^1,2, Rolf E. Steen³ and Astrid Dalhaug²

¹Medical Department, Division of Oncology, Nordlandssykehuset HF, Bodø, Norway. ²Faculty of Medicine, University of Northern Norway, Tromsø, Norway. ³Department of Pathology, Nordlandssykehuset HF, Bodø, Norway.

Abstract  

The authors describe a diagnostically challenging case where a patient with previous squamous cell carcinoma of the tonsil developed a putative second primary squamous cell carcinoma in the lung (stage IV with lung and bone metastases). During palliative chemotherapy several episodes of severe infection occurred, eventually resulting in abscess formation in the hip and brain. The dilemma of distinguishing between metastasis and abscess and the therapeutic implications are discussed.