A female, 50 years of age at diagnosis with Stage IV adenocarcinoma, former smoker with a 22 pack years history (a pack a day for 22 years), had quit 15 years before diagnosis with Stage IV adenocarcinoma with metastasis to bones and brain. Had symptom of pain in rib. First found by x-ray followed by needle biopsy. Molecular testing positive for KRAS mutation. Treated with four rounds of pemetrexed, carbolplaing and bevacizumab and radiation and SRS for brain lesions. Recurrence in rib. No recurrence in brain and remains on maintenance chemotherapy. Had second had smoke exposure at home for 18 years, and a family history of lung cancer (father at age 83 and maternal grandfather at 71) and stomach cancer (maternal grandmother at age 61).