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Updated: Apr 24 2019

Pancoast Tumor

  • 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
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