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QJM : Monthly Journal of the... May 2021
Topics: Humans; Pancoast Syndrome
PubMed: 32790876
DOI: 10.1093/qjmed/hcaa247 -
La Clinica Terapeutica 2019Pancoast's syndrome is caused by malignant neoplasm of superior sulcus of the lung which produces destructive lesions of thoracic inlet and comes along with the... (Review)
Review
BACKGROUND
Pancoast's syndrome is caused by malignant neoplasm of superior sulcus of the lung which produces destructive lesions of thoracic inlet and comes along with the involvement of brachial plexus and stellate ganglion. Computed tomography (CT) or magnetic resonance imaging (MRI) scans can detect early lesions otherwise missed by routine radiographs and can also define the local extent or metastatic progression of the disease. Protocols involving combinations of irradiation, chemotherapy, and surgery are currently being under investigation to determine the best management.
AIMS
This work reviewed the current diagnostic and therapeutic approaches to Pancoast's tumors.
DISCUSSION
Patients with lung superior sulcus carcinoma should be considered for surgery only after an appropriate diagnostic assessment. The perfect candidate for surgery should have a confined to the chest disease with T3N0M0 staging. Inoperable patient with severe pain after irradiation therapy may benefit from palliative surgical resection. Medical therapy plays only a secondary role in lung cancers, patients with disseminated lung cancer might require palliative treatment and medical management of paraneoplastic syndrome symptoms. Following surgery, radiation and chemotherapy may improve local and systemic control by addressing individual adverse findings.
CONCLUSIONS
The cooperation of surgeons, clinicians and radiologists represents the gold standard today and a multidisciplinary approach is essential to achieve the best outcome possible. Further studies are advisable in order to define the best surgical approach and the real advantage of mini-invasive surgery by comparison with open surgery.
Topics: Humans; Pancoast Syndrome
PubMed: 31304518
DOI: 10.7417/CT.2019.2150 -
Expert Review of Respiratory Medicine Dec 2016According to the American College of Chest Physician definition, a Pancoast tumor is a tumor which invades any of the structures of the apex of the chest including the... (Review)
Review
According to the American College of Chest Physician definition, a Pancoast tumor is a tumor which invades any of the structures of the apex of the chest including the first thoracic ribs or periosteum, the lower nerve roots of the bronchial plexus, the sympathetic chain and stellate gaglion near the apex of the chest or the subclavian vessels. Pancoast tumors account for less than 3-5 % of lung tumors. Areas covered: We searched the libraries scopus and pub med and found 124 related manuscripts. From those we chose 18 to include in our short commentary based on the most up-date information included. Expert commentary: The present status of the recommended treatment of Pancoast tumors for patients medically fit for surgical resection is trimodality (chemoradiation followed by radical surgery excersion) as state of the art. Patients with unresectable Pancoast tumors and poor PS 4 or distant metastasis are candidate for radiation therapy for palliation of symptoms and best supportive care. In this mini review we will present up to date information regarding diagnosis and treatment management.
Topics: Combined Modality Therapy; Humans; Lung Neoplasms; Pancoast Syndrome
PubMed: 27786592
DOI: 10.1080/17476348.2017.1246964 -
La Revue Du Praticien Jan 2021
Topics: Humans; Pancoast Syndrome
PubMed: 34160945
DOI: No ID Found -
Clinical and Experimental Obstetrics &... 2017Homer's syndrome (HS) is based on dysfunction of symphathetic nervous system at the cervical canal. The signs of the syndrome occur on the same side as the lesion of the... (Review)
Review
Homer's syndrome (HS) is based on dysfunction of symphathetic nervous system at the cervical canal. The signs of the syndrome occur on the same side as the lesion of the sympathetic trunk and include: a constricted pupil, a weak-droopy eyelid, apparent decreased sweating, and with or without inset eyeball. HS has been observed as a rare complication of epidural anaesthesia in obstetrics during labour or cesarean section. In parturients, it warrants further investigation as other serious causes must be excluded, such as pancoast tumours, thoracic aortic aneurysms, carotid dissection, neuroblastoma, and brainstem vascular malformation. Management involves early diagnosis of the underlying benign condition while treatment is based on appropriate conservative observation, as most often the syndrome resolves spontaneously. However in very rare cases immediate medical or surgical management is needed.
Topics: Anesthesia, Epidural; Cesarean Section; Female; Horner Syndrome; Humans; Pregnancy; Pregnancy Complications
PubMed: 29949268
DOI: No ID Found -
Current Problems in Cancer Apr 2020
Topics: Autonomic Nervous System Diseases; Flushing; Humans; Hypohidrosis; Male; Middle Aged; Pancoast Syndrome; Prognosis
PubMed: 31732238
DOI: 10.1016/j.currproblcancer.2019.100506 -
Annals of Translational Medicine Jun 2016Superior Sulcus Tumors, frequently termed as Pancoast tumors, are a wide range of tumors invading the apical chest wall. Due to its localization in the apex of the lung,... (Review)
Review
Superior Sulcus Tumors, frequently termed as Pancoast tumors, are a wide range of tumors invading the apical chest wall. Due to its localization in the apex of the lung, with the potential invasion of the lower part of the brachial plexus, first ribs, vertebrae, subclavian vessels or stellate ganglion, the superior sulcus tumors cause characteristic symptoms, like arm or shoulder pain or Horner's syndrome. The management of superior sulcus tumors has dramatically evolved over the past 50 years. Originally deemed universally fatal, in 1956, Shaw and Paulson introduced a new treatment paradigm with combined radiotherapy and surgery ensuring 5-year survival of approximately 30%. During the 1990s, following the need to improve systemic as well as local control, a trimodality approach including induction concurrent chemoradiotherapy followed by surgical resection was introduced, reaching 5-year survival rates up to 44% and becoming the standard of care. Many efforts have been persecuted, also, to obtain higher complete resection rates using appropriate surgical approaches and involving multidisciplinary team including spine surgeon or vascular surgeon. Other potential treatment options are under consideration like prophylactic cranial irradiation or the addition of other chemotherapy agents or biologic agents to the trimodality approach.
PubMed: 27429965
DOI: 10.21037/atm.2016.06.16 -
European Journal of Internal Medicine Feb 2019
Topics: Blepharoptosis; Female; Horner Syndrome; Humans; Middle Aged; Miosis; Neurilemmoma; Tomography, X-Ray Computed
PubMed: 30001867
DOI: 10.1016/j.ejim.2018.07.004