Overview Carcinomathat 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