Pancoast tumor with CT guided biopsy

Case contributed by Dr Ian Bickle

Presentation

Smoker. Weight loss.

Patient Data

Age: 70 years
Gender: Female

5cm right apical mass.  No rib destruction.

Heart size normal. Lungs clear.

Normal mediastinal contours.

5cm spiculated mass in the apical segment of the right upper lobe with tethering to the pleural surface.  No satellite nodules.

No supraclavicular or mediastinal lymphadenopathy.

No metastatic disease in the abdomen or pelvis.

Nuclear medicine

5cm FDG avid right upper lobe apical segment mass.

No locoregional or distant metastatic disease.

Prone position.

18G core biopsy of right apical mass.

Case Discussion

This patient encounter illustrates the steps in the diagnosis, work up and histological confirmation with image guided biopsy of a patient with potentially surgically curative lung cancer.

It also illustrates a classical example of a Pancoast tumor.

This was a confirmed lung malignancy that proceeded to surgery.

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