Updated: 4/24/2019

Pancoast Tumor

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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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(M1.ON.13.10) 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? Tested Concept

QID: 100813
FIGURES:
1

Polydipsia

0%

(0/12)

2

Digital clubbing

8%

(1/12)

3

Superior vena cava syndrome

67%

(8/12)

4

Anisocoria

25%

(3/12)

5

Lateral gaze palsy

0%

(0/12)

M 2 E

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Topic COMMENTS (10)
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