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Pancoast's Tumor

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Topic updated on 10/31/17 3:54pm

Overview
  • Carcinoma that occurs in apex of lung 
    • also known as a superior sulcus tumor
    • defined by location
    • bronchogenic adenocarcinoma most common histologic type
      • historically, squamous cell carcinoma was most common
  • Associated conditions
    • Horner syndrome  
      • proximity of the tumor to the superior cervical sympathetic ganglion chain can result in destruction/compression of the chain yielding characteristic
        • ptosis
        • miosis
        • anhidrosis
    • thoracic outlet syndrome 
      • proximity of the tumor to the thoracic outlet of the brachiplexus can result in compression of the C8, T1, and T2 nerve roots yielding characteristic:
        • axillary pain
        • shoulder pain especially along the cervical border of the scapula
        • pain along the ulnar nerve distribution
        • fourth and fifth digit pain, numbness, and muscle atrophy
Presentation
  • Symptoms
    • most common presenting symptom is shoulder pain that radiates to the axilla and scapula 
Evaluation
  • Imaging
    • cancer staging studies
      • CT chest, abdomen, and pelvis
      • MRI
      • PET scan
Treatment
  • Determined by type of tumor and extent of disease


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Qbank (1 Questions)

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(M1.ON.10) A 68-year-old male is diagnosed with squamous cell carcinoma in the upper lobe of his right lung. A chest radiograph can be seen in image A. Which of the following would you most expect to find in this patient? Topic Review Topic
FIGURES: A          

1. Polydipsia
2. Digital clubbing
3. Superior vena cava syndrome
4. Anisocoria
5. Lateral gaze palsy

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