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Lung cancer continues to be the number one cancer killer among men and women in the United States. Smoking stands as the primary risk factor for developing lung cancer. Consequently, primary lung cancer may act differently in young adults than expected in older adults. Many young adults diagnosed with lung cancer are never smokers and otherwise healthy. Genetic driver mutations are often found in these young adults and targeted therapy is initiated. We present a case of a 23-year-old intravenous drug user found to have advanced stage lung cancer during work up of an apparent empyema.

Advanced Stage Primary Lung Cancer Masquerading as Empyema in a 23-Year-Old Male