Pancoast Tumour

PANCOAST TUMOUR


PANCOAST TUMOUR

  • Pancoast tumour or superior sulcus tumour is a bronchogenic carcinoma arising from the apex of the lung.
  • Involvement of structures-
  1. Apical chest wall above the level of the 2nd rib
  2. Brachial plexus
  3. First ribs
  4. Vertebrae
  5. Subclavian vessels or stellate ganglion
  • Pancoast’s syndrome refers to-
  1. Pancoast’s tumour
  2. Erosion of the first rib
  3. Paralysis of C8 & T1 nerve roots
  4. Horner’s syndrome
Horner’s syndrome consists of unilateral enophthalmos, ptosis, miosis, and loss of sweating over the ipsilateral half of the face or forehead (anhidrosis). It is caused by ipsilateral involvement of the sympathetic pathways in the carotid plexus, the cervical sympathetic chain, the upper thoracic cord, or the brain stem. 

ETIOLOGY-

  • Chronic smoker
  • Mesothelioma
  • Metastatic neoplasm
  • Hematologic neoplasm
  • Bacterial infection
  • Fungal infection
  • TB

CLINICAL FEATURES-

  • Seen in elderly male around 70 years
  • Common as squamous cell carcinoma
  • Cough, weight loss , dyspnoea and chest pain, clubbing
  • Tumour is hard in consistency, fixed, irregular.
  • Severe pain in shoulder

INVESTIGATIONS-

  • X- ray shows a dense mass
  • CT scan shows infiltration of tumour into ribs
  • Bronchoscopy shows tissue biopsy and sputum analysis
  • FNAC helps in diagnosis the disease

  

TREATMENT-

  • Pallliative radiotherapy

Exam Important

  • Pancoast tumour or superior sulcus tumour is a bronchogenic carcinoma arising from the apex of the lung.

 

 

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