A solitary pulmonary mass is a common presentation of lung cancer. However, other inflammatory or infectious diseases, such as pulmonary tuberculosis (TB), also present similar imaging characteristics and may coexist with lung cancer. This makes the diagnosis and identifying the correct tumor stage difficult for physicians. Herein we present the case of a patient with coexisting lung squamous cell carcinoma and active pulmonary TB infection, which presented a solitary pulmonary mass. Tissue biopsy was performed twice via different approaches. However, imaging studies could not confirm the diagnosis and tumor stage, which were finally established after surgical intervention.