Pancoast tumor 1017833 225080038 2008-07-11T19:54:43Z Arcadian 104523 nav {{Infobox_Disease | Name = {{PAGENAME}} | Image = | Caption = | DiseasesDB = 31266 | ICD10 = {{ICD10|C|34|1|c|30}} | ICD9 = {{ICD9|162.3}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 3418 | MeshID = D010178 | }} A '''pancoast tumor''', also '''pancoast tumour''' (UK) or '''superior sulcus tumor''', is a [[lung cancer|tumor]] of the [[lung|pulmonary]] apex i.e. a type of lung cancer defined primarily by its location situated at the top end of either the right or left lung. The growing tumor can cause compression of a [[brachiocephalic vein]], [[subclavian artery]], [[phrenic nerve]], [[recurrent laryngeal nerve]], [[vagus nerve]], or, characteristically, compression of a [[sympathetic nervous system|sympathetic]] [[ganglion]] resulting in a range of symptoms known as [[Horner's syndrome]]. Pancoast tumors are named for [[Henry Pancoast]], a US [[radiologist]], who described them in 1924 and 1932.<ref>{{WhoNamedIt|synd|2953}}</ref> ==Symptoms== Symptoms can include [[miosis]] (constriction of the pupils), [[anhidrosis]] (lack of sweating), ptosis (drooping of the eyelid), and in severe cases, a complete [[Horner's syndrome]]. In progressive cases, the [[brachial plexus]] is also affected, causing [[pain]] and [[weakness]] in the muscles of the [[arm]] and [[hand]]. The tumour can also compress the right recurrent laryngeal nerve, a hoarse voice and bovine cough may also occur. In [[superior vena cava syndrome]], obstruction of the [[superior vena cava]] by a tumor (mass effect) causes facial swelling, [[cyanosis]] and dilatation of the veins of the head and neck. A pancoast tumor is an apical tumor that is typically found in conjunction with a smoking history. The clinical signs and symptoms can be confused with neurovascular compromise at the level of the thoracic outlet. The patient's smoking history, rapid onset of clinical signs and symptoms, and pleuritic pain can suggest an apical tumor. ==Treatment== The treatment of a Pancoast lung cancer may differ to that of other types of non-small cell lung cancer due to its position and close proximity to vital structures (such as nerves and spine) which may make surgery difficult to be undertaken. As a result, and depending on the stage of the cancer, treatment may often involve radiation and chemotherapy given pre-operatively ([[neoadjuvant]] treatment) prior to surgery. Surgery may consist of the removal of upper lobe of the lungs together with its associated structures ([[subclavian artery]], [[vein]], branches of the [[brachial plexus]], ribs and [[vertebral bodies]]), as well as [[mediastinal]] [[lymphadenectomy]]. Surgical access may be via [[thoracotomy]] from the back (Paulson<ref> Ann Surg 1961;54:29–40</ref>) or the front of the chest (Dartevelle <ref>J Thorac Cardiovasc Surg 1993;105:1025–1034</ref>and modifications<ref> J Thorac Cardiovasc Surg 1996;112:558-9. </ref><ref>Ann Thorac Surg 1997;63:563-6</ref>[http://www.youtube.com/watch?v=x67dV8n7asI]) ==References== <references /> ==External links== * {{eMedicine|radio|515|Pancoast Tumor}} * [http://meded.ucsd.edu/isp/1994/im-quiz/pancoast.htm UCSD-Xray] [[Category:Pulmonology]] [[Category:Types of cancer]] {{oncology-stub}} {{Respiratory tract neoplasia}} [[de:Pancoast-Tumor]] [[fr:Syndrome de Pancoast-Tobias]] [[pl:Guz Pancoasta]] [[pt:Tumor de Pancoast]]