Pancoast tumor

Case contributed by Mohamed Mahmoud Elthokapy


Right shoulder and hand pain, tingling and numbness slowly worsening over 6 weeks.

Patient Data

Age: 50 years
Gender: Male

The patient's scout demonstrates opacity of the right lower neck, right lung apex and destruction of the right first rib. CT images show a large soft tissue mass involving the apex of the right lung with subsequent marked destruction of the proximal end of the right 1st rib, transverse process the right border of T1 and T2 vertebrae. Superiorly it extends to the neck. It measures about 7.7 x 7.2 x 7.9 cm at maximum AP, TV and CC dimensions respectively. It encroaches upon right thoracic inlet with right cervico-thoracic neuro-vascular compromise.

Right lower lung basal multiple small sized pulmonary nodules (sub-centimetric) with surrounding ground glass veiling.

Large retrocaval lymph node based on limited non-enhanced study.

Case Discussion

An irregular ill defined soft tissue mass seen arising from the apical segment of the right upper lobe and infiltrates the adjacent ribs and vertebral transverse process with extra-thoracic extension.

Pancoast tumors are an eponymous name for apical or superior sulcal lung cancers

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