53 yr female presented with backache for 6 months, cough & shortness of breath for 1 month and loss of appetite. On investigation CECT showed an irregularly marginated heterogenously enhancing soft tissue density mass which appears to be limited by the oblique fissure in the post segment of RUL with multiple tiny intraparenchymal nodules in right lung lower lobe. A left paravertebral STD mass at D9/10 with bony erosion of adjacent 10th rib. CECT head showed left hemisphenidal moderately enhancing polypoidal soft tissue lesion 18.7x17x16.8mm with adjacent calvarial erosion. Sphenoidal roof, lateral wall focal erosion with partial encasement of ipsilateral paraclinoidal ICA. Left medial temporal lobe leptomeningeal infiltration seen. CT guided biopsy lung mass came out to be adenocarcinoma lung, IHC:CK-7, TTF1, NAPSIN-A: Positive, CK20-negative, EGFR & ALK negative. Bone scan had osteoblastic skeletal metastases to D9/10, left 10th rib, L5, hypertrophic pulmonary osteoarthropathy. Received pemetrexed+carboplatin with bisphosphonate therapy & palliative RTto involved painful bony lesion. She complained of severe pain right face and numbness and slowly patient had decrease in vision right eye and decrease in size of right eye. Neurosurgical evaluation declined by the patient. Patient chest symptoms and backache improved as well her appetite except the opthalmic symptoms. Post 6 cycle of pem+carbo she had progressive disease with lytic lesions involving body of C6/C7 vertebrae and CECT head comparative scan shows no interval changes with stable nature of disease intracranial lesion. Total treatment received: Systemic chemotherapy 6 cycles 29/3/2017-06/10/2017 of Inj. pemetrexed & caboplatin D1 X 3 weekly, zoledronic acid 4mg 4 weekly, palliative radiotherapy and palliative care.