Presentation
Right upper chest pain radiating to the shoulder in a heavy smoker.
Patient Data
Irregular ill-defined soft tissue mass of the right lung apex containing foci of calcification and central necrotic areas with heterogeneous enhancement following IV contrast. There is invasion of the pleura, adjacent 2nd intercostal space and the spinal canal through the T2-T3 exit foramina. The bone window shows erosion of the inferior margin of the posterior arch of the right 2nd rib. A small right suprahilar mass suggestive of lymphadenopathy. Right supraclavicular and mediastinal lymphadenopathy mainly of right paratracheal location.
Background of paraseptal and centrilobular emphysema is noted.
Case Discussion
CT features of a Pancoast tumor invading the pleura, intercostal space and spinal canal through the adjacent exit foramina with supraclavicular and mediastinal lymphadenopathy (biopsy proven as squamous cell carcinoma).
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