Pancoast syndrome

Background

• Syndrome resulting from compression of extrathoracic structures by Pancoast tumor (aka superior sulcus tumor)
• Majority are squamous cell carcinomas or pulmonary adenocarcinomas
• Symptoms arise from compression of the sympathetic chain and brachial plexus

Clinical Features

• Shoulder pain most common initial symptom
• Horner syndrome
• Ipsilateral arm and hand weakness, parasthesias, and atrophy (from compression of brachial plexus)
• May result in congestion from compression of subclavian vessels

Evaluation

Chest X-ray showing a Pancoast tumor (labeled as P, non-small cell lung carcinoma, right lung).

CT scan showing a Pancoast tumor (labeled as P, non-small cell lung carcinoma, right lung).