Presentation
Painful left shoulder and scapula following fall.
Patient Data
Age: 80 years
Gender: Male
From the case:
Left apical pancoast tumor on shoulder x-ray
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Frontal
- no shoulder fracture or dislocation
- large left upper lobe pulmonary lesion with an irregular margin
- linear opacity within the left mid-zone, likely reflecting atelectasis
- some ill-definition of the left upper ribs
From the case:
Left apical pancoast tumor on shoulder x-ray
Axial lung window
- the CT confirms the presence of a left upper lobe mass, which is eroding several upper thoracic ribs
- the mass is fairly homogenous in its appearance
- evidence of background emphysematous changes
Case Discussion
This case illustrates the importance of the hemithoraces as a check area on shoulder x-ray - it is important not to miss lung abnormalities, particularly cancer.
This patient went on to have completion CT imaging as well as a CT/PET scan, confirming the diagnosis of a Pancoast tumor.