Right para-spinal invasive and right apical masses in the chest are equivocal if completely extrapulmonary. 

Differential diagnoses include a metastatic disease or primary lung neoplasm. Lymphoma is felt unlikely given the aggressive bone destruction pattern. 

A spinal mass biopsy was performed and confirmed metastatic NSCLC. 

This represents stage IV disease and has been treated with radiotherapy and has planned to start immunotherapy (Pembrolizumab).