Hematogenous dissemination of non-small cell lung carcinoma (NSCLC) metastatic to skeletal musculature in the absence of osseous involvement is an infrequent occurrence. We retrospectively reviewed our institution's indexed database for patients evaluated from 1975 through 1997 who were diagnosed as having skeletal musculature metastases from NSCLC. Eight men and 2 women were identified (age range, 51-80 years at time of metastases). Four primary adenocarcinomas, 4 primary lung squamous cell carcinomas (SCCs), and 2 poorly differentiated primary NSCLCs were identified. Approximate tumor sizes ranged from 10 cm3 to 288 cm3. External-beam radiation therapy was used in 7 of 10 cases; complete surgical excision was performed in 3 cases. Patients with known neoplasm who have extremity pain and negative findings on bone scan should be evaluated for soft tissue tumor involvement because such findings significantly affect clinical management. One case of lung SCC metastatic to the quadratus femoris muscle in a 63-year-old man is discussed in detail.