A 63-year-old man with recurred squamous cell lung carcinoma was admitted to our facility due to an acute onset of chest and upper back pain. He had undergone a left pneumonectomy in July of 2004, and had been receiving EGFR-TKI (Tarceva^Ⓡ) as a 3rd line treatment since he had relapsed. His electrocardiographic findings (Panel A) showed acute lateral wall myocardial infarction, and his cardiac enzymes were slightly elevated. 2D-echocardiography and chest CT (Panel B) disclosed the presence of metastatic cancer invading the myocardium along the left circumflex coronary artery, however, there was no critical stenosis observed during a coronary angiography (Panel C). His pain was relieved gradually by medical treatment that included an angiotensin converting enzyme inhibitor, β-blocker and opioids. After this treatment, a 4th line treatment was initiated.