When there is an inexplicable strong pain in the neck and shoulder, don’t mistake it for “frozen shoulder”, as lung cancer can also cause shoulder pain when it compresses the brachial plexus nerve. Unlike frozen shoulder, lung cancer has many other symptoms besides hidden pain in the chest and shoulder, such as cough and hemoptysis that cannot be cured for a long time. Benign tumors Benign bone tumors such as osteoma, osteoid osteoma, osteochondroma, chondroblastoma, etc.; tumor-like diseases such as isolated bone cyst, aneurysmal bone cyst, bone fibrous dysplasia, osteophilic red granuloma, bone hemangioma, etc. Diagnostic points: (1) Pain characteristics: Long-term presence may be painless, and some may be found incidentally by radiography after other diseases or trauma. (3) Benign tumors of the cervical spine may cause symptoms if they compress the spinal cord; (4) Benign tumors and tumor-like lesions that destroy bone structure are prone to fracture due to trauma; (5) Normal blood tests; (6) Imaging tests: X-rays, CT, etc. for benign tumors or tumor-like lesions; (7) If necessary (7) If necessary, tissue biopsy should be performed to confirm the diagnosis. Primary malignant bone tumors: osteosarcoma, parosteal osteosarcoma, Ewing’s sarcoma, chondrosarcoma, chordoma, myeloma, etc. can occur in the neck and shoulder bones. Diagnostic points: (1) Pain characteristics: with the development of the disease, the pain gradually worsens, from intermittent hidden pain to persistent severe pain; (2) the swelling is often palpable in the neck and shoulder, with rapid development and obvious pressure pain; (3) there may be systemic symptoms in the early stage, such as hypothermia and progressive wasting; (4) there are mostly anemia, leukocytosis and rapid blood sedimentation. Osteosarcoma has increased blood alkaline phosphatase, Ewing’s sarcoma has a positive rate of urinary catecholamines up to 90%, and myeloma patients have increased urinary Bence Jones protein; (5) imaging: X-ray, CT, MRI have specific manifestations such as bone destruction of corresponding malignant bone tumors; (6) isotope scan has specific nuclear concentration changes; (7) pathological examination has Confirmation value. Primary bone tumors with malignant tendency Osteoblastoma and giant cell tumor of bone are mostly benign, but some of them can be transformed into malignant. Diagnostic points: (1) Pain characteristics: pain is generally mild, mostly localized and vague, a few may have radicular or dry neuralgia. If it turns malignant, the pain increases; (2) Generally no systemic symptoms, and the mass grows slowly. If it turns malignant, the mass grows fast and may have systemic symptoms; (3) The blood biochemistry and sedimentation are normal in benign cases, but the sedimentation may be accelerated and anemia in malignant cases; (4) The changes of X-ray and CT are fast in malignant cases and have the characteristics of malignant tumor; (5) Pathological examination has the value of confirming the diagnosis. (1) Pain characteristics: vague pain in the early stage, gradually worsening and developing fast, especially at night, and cannot be relieved by general painkillers (2) history of malignant tumors such as breast cancer, lung cancer, thyroid cancer, etc., or no history of malignant tumors; (3) systemic reaction; (4) accelerated blood sedimentation; (5) X-ray, CT film or MRI suggesting osteolytic bone destruction, and periosteal reaction is not obvious (6) abnormal changes on nuclear scan; (7) tissue biopsy, if necessary, has a confirmatory value.