Herein a 46 year-old man is presented with intolerable severe pain of right shoulder radiating to right arm and fourth and fifth fingers. He had a history of right upper lobectomy due to complicated tuberculosis eight years ago. Based on the findings of clinical examination and computed tomography imaging, diagnosis of Pancoast tumor of the right chest apex was confirmed. However, Fine Needle Aspiration (FNA) under computed tomography (CT) guidance was not conclusive. By performing a limited thoracotomy, multiple biopsy specimens were obtained from the mass and destroyed ribs for histopathologic examination which consequently confirmed the diagnosis of squamous cell carcinoma. Eventually, the patient was referred to the radiotherapy ward for treatment of Pancoast tumor.