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La Revue Du Praticien Jan 2021
Topics: Humans; Pancoast Syndrome
PubMed: 34160945
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 -
The American Journal of Case Reports Jul 2022BACKGROUND Pancoast tumors, also called superior sulcus tumors, are a rare type of cancer affecting the lung apex. These tumors can spread to the brachial plexus and... (Review)
Review
BACKGROUND Pancoast tumors, also called superior sulcus tumors, are a rare type of cancer affecting the lung apex. These tumors can spread to the brachial plexus and spine and present with symptoms that appear to be of musculoskeletal origin. CASE REPORT A 59-year-old Asian man presented to a chiropractor in Hong Kong with a 1-month history of neck and shoulder pain and numbness that had been treated unsuccessfully with exercise, medications, and acupuncture. He had an active history of tuberculosis, which was currently treated with antibiotics, and a 50-pack-year history of smoking. Cervical magnetic resonance imaging (MRI) was performed urgently, revealing a small cervical disc herniation thought to correspond with radicular symptoms. However, as the patient did not respond to a brief trial of care, a thoracic MRI was urgently ordered, revealing a large superior sulcus tumor invading the upper to mid-thoracic spine. The patient was referred for medical care and received radiotherapy and chemotherapy with a positive outcome. A literature review identified 6 previously published cases in which a patient presented to a chiropractor with an undiagnosed Pancoast tumor. All patients had shoulder, spine, and/or upper extremity pain. CONCLUSIONS Patients with a previously undiagnosed Pancoast tumor can present to chiropractors given that these tumors may invade the brachial plexus and spine, causing shoulder, spine, and/or upper extremity pain. Chiropractors should be aware of the clinical features and risk factors of Pancoast tumors to readily identify them and refer such patients for medical care.
Topics: Brachial Plexus; Chiropractic; Humans; Intervertebral Disc Displacement; Male; Middle Aged; Neck Pain; Pancoast Syndrome
PubMed: 35797264
DOI: 10.12659/AJCR.937052 -
Current Opinion in Pulmonary Medicine Jul 2013Pancoast tumors, also known as superior sulcus tumors, to this day remain a complex and challenging condition. This review will explore the evolution of the treatment of... (Review)
Review
PURPOSE OF REVIEW
Pancoast tumors, also known as superior sulcus tumors, to this day remain a complex and challenging condition. This review will explore the evolution of the treatment of these tumors over the better part of a century. It will illustrate how with a multidisciplinary approach and the use of trimodality therapy this entity has evolved from a universally fatal disease to one that is treatable with outcomes similar to those of other stage-matched nonsmall cell lung cancers.
RECENT FINDINGS
The Southwest Oncology Group 9416 Intergroup 0160 trial reported in 2007 By Rusch et al. culminated years of research showing that trimodality therapy with chemotherapy, radiation and surgery provided optimal outcomes. Since that time, there have been studies corroborating these outcomes and utilization of novel surgical approaches including Video-assisted thoracoscopic surgery; however, no change in survival has been reported.
SUMMARY
The treatment of tumors of the superior sulcus has evolved over the years, so that outcomes approach those of other stage-matched nonsmall cell carcinomas. In the future, new approaches, perhaps the detailed genetic analysis of tumors and guided treatments, will have a positive impact on nonsmall cell carcinomas. The tumors of the superior sulcus will hopefully follow suit in their improved outcomes.
Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Combined Modality Therapy; Female; History, 20th Century; History, 21st Century; Humans; Lung Neoplasms; Male; Pancoast Syndrome; Prognosis; Radiotherapy Dosage; Robotics; Survival Rate; Thoracic Surgery, Video-Assisted; Treatment Outcome
PubMed: 23702478
DOI: 10.1097/MCP.0b013e3283621b31 -
Journal of Investigative Medicine High... 2023Pancoast tumor is a rare and aggressive form of lung cancer; cardiac metastasis is very uncommon. We present a case of advanced Pancoast tumor, with extensive cardiac...
Pancoast tumor is a rare and aggressive form of lung cancer; cardiac metastasis is very uncommon. We present a case of advanced Pancoast tumor, with extensive cardiac metastases and intracardiac thrombosis in a woman presenting with dyspnea, shoulder pain, and weight loss. A contrast-enhanced chest computed tomographic scan revealed an apical mass, metastatic thoracic nodes, and filling defects within both ventricles. Further imaging with cardiac magnetic resonance imaging revealed 2 left ventricular masses infiltrating into the myocardium suggestive of metastatic disease, and a multilobulated mass within the right ventricle suggestive of intracardiac thrombus. She was initiated on anticoagulation for intracardiac thrombosis. Surgical pathology of biopsied tissue samples was consistent with advanced metastatic lung adenocarcinoma. She was a poor candidate for surgical intervention. Given the patient's goals of care, she was ultimately transitioned to comfort care.
Topics: Female; Humans; Pancoast Syndrome; Heart Neoplasms; Lung Neoplasms; Thrombosis; Adenocarcinoma of Lung
PubMed: 36772879
DOI: 10.1177/23247096231154642 -
Journal of Medical Case Reports Mar 2022Pancoast tumors represent a unique subset of lung cancers wherein a primary neoplasm arises in the lung's apex and invades the surrounding soft tissues. One of the main...
BACKGROUND
Pancoast tumors represent a unique subset of lung cancers wherein a primary neoplasm arises in the lung's apex and invades the surrounding soft tissues. One of the main challenges in the diagnosis and treatment of these apical lung cancers is that they are usually not visualized on initial chest x-ray and, by the time the patient presents with symptoms, the tumor has almost always invaded nearby structures.
CASE PRESENTATION
Herein we report a case of a 58-year-old nonsmoking African American male who presented to the neurology clinic with a history of multiple chronic joint pains. The patient complained of shoulder pain that traveled into his right arm and right finger and had worsened over the past 9 months. The patient also reported decreased right proximal strength and swelling of his right hand. Magnetic resonance imaging of the shoulder and cervical region showed mild cervical spondylosis and a questionable right apical mass. A subsequent high-resolution computed tomography scan of the chest revealed a large right apical lung mass, with chest wall invasion and erosion of the adjacent ribs. Biopsy of the mass confirmed poorly differentiated non-small cell lung cancer. Radiation therapy was initiated, and the patient's pain improved significantly. Given the size of the tumor, chemotherapy was recommended by the oncology team. The patient decided against chemotherapy.
CONCLUSION
This case highlights the importance of early diagnosis by expanding the differential diagnosis in patients presenting with weakness, sensory loss, and shoulder pain beyond radiculopathy or joint-related diseases. A comprehensive history and careful examination may lead to an earlier diagnosis, more appropriate treatment, and better outcome in cases of Pancoast tumor presenting with neuropathic or musculoskeletal pain.
Topics: Carcinoma, Non-Small-Cell Lung; Humans; Lung Neoplasms; Male; Middle Aged; Pancoast Syndrome; Shoulder Pain; Tomography, X-Ray Computed
PubMed: 35292093
DOI: 10.1186/s13256-022-03328-4 -
The Annals of Thoracic Surgery Apr 1984Until 1956, surgical attempts to remove a Pancoast tumor had proven futile, since the neoplasm invades the endothoracic lymphatics, the sympathetic chain, intercostal...
Until 1956, surgical attempts to remove a Pancoast tumor had proven futile, since the neoplasm invades the endothoracic lymphatics, the sympathetic chain, intercostal nerves, ribs, bodies of the vertebrae, and subclavian vessels. In 1956, a man believed to have a nonresectable tumor received 3,000 rads over the upper right chest. Three weeks later, his superior sulcus tumor had shrunk to one-half its original size. At operation, en bloc resection of portions of the upper three ribs, along with the upper lobe of the lung, was accomplished. The patient is alive 27 years later and has only minor complications. Several other patients were successfully treated with this combined therapy, although those with distant metastases, supraclavicular tumefaction, obvious erosion of the transverse processes, extensive involvement of the brachial plexus, and vena caval obstruction are not suitable candidates for this approach.
Topics: Combined Modality Therapy; Humans; Pancoast Syndrome; Radiography, Thoracic; Radiotherapy Dosage
PubMed: 6712336
DOI: 10.1016/s0003-4975(10)60743-6 -
QJM : Monthly Journal of the... May 2021
Topics: Humans; Pancoast Syndrome
PubMed: 32790876
DOI: 10.1093/qjmed/hcaa247 -
Annali Italiani Di Chirurgia 1993
Review
Topics: Combined Modality Therapy; Humans; Neoplasm Staging; Pancoast Syndrome; Pneumonectomy; Preoperative Care; Prognosis; Thoracotomy
PubMed: 8109811
DOI: No ID Found -
Nature Clinical Practice. Oncology Sep 2006The management of Pancoast tumors has challenged surgeons and radiation and medical oncologists over several decades. Retrospective studies have raised a greater... (Review)
Review
The management of Pancoast tumors has challenged surgeons and radiation and medical oncologists over several decades. Retrospective studies have raised a greater awareness of the importance of positive N2 lymph nodes in terms of prognosis and treatment decision making. While patients with positive N2 lymph nodes have generally been excluded from trials of preoperative chemoradiation for superior sulcus tumors, the potential of surgery for these patients is still being evaluated. The role of PET for initial staging as well as for assessment of disease response to induction therapy continues to evolve. The use of combined treatment modalities has enhanced the progress in successfully treating Pancoast tumors. The historical data showing improved results with a combination of surgery and radiation compared with surgery alone for patients with positive N2 nodes provides the basis for several important clinical trials that integrate the use of chemotherapy into the treatment paradigm. The Southwest Oncology Group and Japanese Clinical Oncology Group have shown dramatic improvements in complete resection rates following a neoadjuvant course of combined chemotherapy and radiation therapy compared with historical series. We discuss relevant ongoing clinical trials that include consolidative taxane-based chemotherapy and the role of prophylactic cranial irradiation in complete responders. Future potential areas of investigation, including the role of surgery for patients with N2-positive disease and the use of imaging to assess response after induction therapy, are discussed.
Topics: Combined Modality Therapy; Humans; Pancoast Syndrome
PubMed: 16955087
DOI: 10.1038/ncponc0584