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Cureus Jan 2024[This retracts the article DOI: 10.7759/cureus.19418.].
[This retracts the article DOI: 10.7759/cureus.19418.].
PubMed: 38274616
DOI: 10.7759/cureus.r94 -
Multimedia Manual of Cardiothoracic... Nov 2023The current gold standard for the treatment of Pancoast tumours is considered to be neoadjuvant chemoradiation followed by radical resection of the affected upper lobe...
The current gold standard for the treatment of Pancoast tumours is considered to be neoadjuvant chemoradiation followed by radical resection of the affected upper lobe en bloc with resection of the chest wall. Shaw and Paulson first described the most commonly used approach in 1961 via an extended posterolateral thoracotomy. However, because this approach comes with significant soft tissue damage and occasionally provides only suboptimal exposure, especially for anterior superior sulcus tumours, other approaches have been published in recent years, including open anterior approaches (Dartevelle and Gruenenwald) in addition to rare case reports of minimally invasive assisted hybrid procedures. Because we routinely perform robotic anatomical lung resections as well as three-port robotic first rib resections for thoracic inlet/outlet syndrome in our department, combining both techniques with our accumulated experience seemed to be the next logical step. We describe step-by-step what is (to our knowledge) one of the first reported cases of a fully portal robotic-assisted Pancoast tumour resection consisting of a left upper lobe resection en bloc with the first rib after neoadjuvant chemoradiation therapy. This approach proved to be safe and allowed for excellent exposure, especially of the thoracic outlet.
Topics: Humans; Pancoast Syndrome; Thoracic Wall; Robotic Surgical Procedures; Lung Neoplasms; Lung
PubMed: 37970683
DOI: 10.1510/mmcts.2023.072 -
Radiology Case Reports May 2024Pancoast tumors, also known as superior sulcus tumors, encompass a diverse spectrum of neoplasms that infiltrate the apex of the chest wall, yielding distinctive...
Pancoast tumors, also known as superior sulcus tumors, encompass a diverse spectrum of neoplasms that infiltrate the apex of the chest wall, yielding distinctive clinical presentations. One of the earliest signs of tumor growth is pain radiating to the upper limb, stemming from peripheral nerve involvement, which can mimic joint pain or spinal radicular irritation. In this case report, we present the clinical history of a 64-year-old female smoker who had previously been recommended for orthopedic elbow surgery due to epicondylitis. Subsequent to the development of additional symptoms and rigorous investigation, a Pancoast tumor was diagnosed. Furthermore, we discuss the characteristic treatment modalities available for Pancoast tumors, including pharmacological pain management and interventional strategies such as spinal cordotomy and spinal alcoholysis. This case underscores the significance of recognizing atypical presentations and emphasizes the importance of comprehensive evaluation in the diagnosis and management of Pancoast tumors.
PubMed: 38406318
DOI: 10.1016/j.radcr.2024.01.091 -
Experimental and Therapeutic Medicine Dec 2023A superior pulmonary sulcus tumor, also known as a Pancoast tumor, invades tissues or organs at the entrance of the thorax, such as the brachial plexus, upper ribs,...
A superior pulmonary sulcus tumor, also known as a Pancoast tumor, invades tissues or organs at the entrance of the thorax, such as the brachial plexus, upper ribs, vertebrae, subclavian vessels and stellate ganglia. Induction concurrent chemoradiotherapy followed by radical surgical resection is the preferred treatment. The present study reported the case of a 52-year-old male who presented at Hubei Cancer Hospital, Tongji Medical College (Wuhan, Hubei) with left chest pain and an abnormal chest computed tomography scan showing a mass of 81x43 mm in the left upper chest wall that invaded the first, second and third anterior ribs. Biopsy of the mass showed stage cT4N0M0, IIIA, poorly differentiated adenocarcinoma and epidermal growth factor receptor+. The patient was treated by induction chemotherapy and targeted therapy, which was followed by surgical resection of the left upper lobe and the affected chest wall via the transmanubrial approach. The targeted therapy with almonertinib was continued postoperatively. To date, no disease recurrence has been detected during the 4 months follow-up.
PubMed: 37954117
DOI: 10.3892/etm.2023.12263 -
The Journal of Thoracic and... Dec 2023
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Pancoast Syndrome; Combined Modality Therapy
PubMed: 37831023
DOI: 10.1016/j.jtcvs.2023.09.024 -
Multimedia Manual of Cardiothoracic... Mar 2024We describe a rare procedure involving near-total robotic-assisted thoracoscopic surgery resection of a right posterior Pancoast tumour. Four ports and an assistant port...
We describe a rare procedure involving near-total robotic-assisted thoracoscopic surgery resection of a right posterior Pancoast tumour. Four ports and an assistant port were used. The DaVinci X system was used. The lobectomy was performed first to allow for adequate exposure to the apex and spine. The lateral aspect of ribs 1 to 4 was resected next, and the extrathoracic space was entered. Dissection proceeded through this space superiorly up to the level of the scapula and then posteriorly towards the spine. The second to the fifth ribs were dissected off the chest wall and resected medially off the spine at the rib heads. Further postero-superior exploration revealed the tumour to be invading the transverse process of the second rib, with ill-defined margins. Because of this development, and with the support of the spinal surgeons, a small high posterior thoracotomy was performed to complete the procedure and remove the specimen en bloc. The postoperative recovery was uneventful, and the patient was discharged on post-operative day 5. The final histological report confirmed a squamous non-small-cell lung cancer (pT3N0M0) with negative margins (R0). Asymptomatic recurrence was noted near the margin of the second rib resection posteriorly 1 year postoperatively and was successfully treated with radiotherapy.
Topics: Humans; Robotic Surgical Procedures; Thoracic Wall; Carcinoma, Non-Small-Cell Lung; Pancoast Syndrome; Lung Neoplasms; Thoracoscopy
PubMed: 38526520
DOI: 10.1510/mmcts.2023.063 -
Clinical Case Reports Apr 2024PET-driven SBRT plus pembrolizumab as first-line therapy against pleomorphic Pancoast cancer appears beneficial, probably due to high equivalent doses of SBRT on...
PET-driven SBRT plus pembrolizumab as first-line therapy against pleomorphic Pancoast cancer appears beneficial, probably due to high equivalent doses of SBRT on photopenic necrotic core and synergic immune system stimulation of immunoradiotherapy.
PubMed: 38585585
DOI: 10.1002/ccr3.8633