Pancoast syndrome (apical lung tumor)

General or Other | - Others | Pancoast syndrome (apical lung tumor) (Disease)


Pancoast syndrome is characterized by a malignant neoplasm of the superior sulcus of the lung with destructive lesions of the thoracic inlet and involvement of the brachial plexus and cervical sympathetic nerves. This is accompanied by severe pain in the shoulder region radiating toward the axilla and scapula along the ulnar aspect of the muscles of the hand, atrophy of hand and arm muscles,

It invades the surrounding tissues and produces:

(1) An ipsilateral invasion of the cervical sympathetic plexus leading to Horners syndrome(miosis, enophthalmos, ptosis; only in 20% of patients)

(2) Ipsilateral reflex sympathetic dystrophy may occur

(3) Shoulder and arm pain (brachial plexus invasion C8-T2) leading to wasting of the intrinsic hand muscles and paraesthesiae in the medial side of the arm

(4) Less commonly unilateral recurrent laryngeal nerve palsy producing unilateral vocal cord paralysis (hoarse voice ± bovine cough), and/or phrenic nerve involvement

(5)There may be arm oedema secondary to the compression of blood vessels

Causes and Risk factors

The risk factors for almost all lung cancers are similar. These include the following: smoking, secondary smoke exposure, prolonged asbestos exposure, exposure to industrial elements (e. g. gold, nickel).

Diagnosis and Treatment

History and physical exam will be performed. Imaging tests to determine the extent of disease include: X-ray, CT scan, Positron Emission Tomagraphy (PET) scan and/or MRI. The type of cancer is determined by performing a bronchoscopy and/or a mediastinoscopy, and a biopsy. Treatment depends on the extent of disease but may include: surgery, chemotherapy, and/or radiation therapy. ...