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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 -
Indian Journal of Nuclear Medicine :... 2023We present the case of a 52-year-old male who was recently diagnosed case of a Pancoast tumor and presented to the pulmonary outpatient department with a complaint of...
We present the case of a 52-year-old male who was recently diagnosed case of a Pancoast tumor and presented to the pulmonary outpatient department with a complaint of pain in the shoulder and chest region which was burning type, associated with shoulder abduction weakness and poor hand grip. Subsequently, he was referred for a -Tc bone scan for metastatic workup, which showed increased uptake in all the joints and long bones of the ipsilateral upper limb. This case highlights the importance of considering nontraumatic cause of pattern similar to complex regional pain syndrome.
PubMed: 38390551
DOI: 10.4103/ijnm.ijnm_38_23 -
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 -
Journal of Chiropractic Medicine Dec 2023The purpose of this report was to describe a patient with a Pancoast tumor who presented for chiropractic care with neck and arm pain.
OBJECTIVE
The purpose of this report was to describe a patient with a Pancoast tumor who presented for chiropractic care with neck and arm pain.
CLINICAL FEATURES
A 52-year-old male patient with right-sided cervicothoracic pain and numbness in the right upper extremity presented to a chiropractic office for care. The patient reported an occupational history of repetitive lifting motions and overuse injuries. The patient denied history of smoking at the time of presentation.
INTERVENTION AND OUTCOME
Radiographic imaging revealed tracheal deviation. A chest computed tomography image demonstrated a large lesion in the apex of the right lung, suggestive of bronchogenic carcinoma. The patient was referred to an oncology clinic, where he admitted to having a 20-year history of smoking. The diagnosis of adenocarcinoma was made via biopsy, and the oncologist's evaluation confirmed the cancer to be stage IIIC. The patient received palliative care treatments, as the advanced state of his condition determined that he was not a candidate for surgical intervention.
CONCLUSION
Chiropractors and other first-contact health care providers must keep in mind unusual presentations masquerading as common conditions. This case demonstrates the importance of including apical lung tumors in the differential diagnosis of unilateral arm and neck pain and neurologic deficits of the upper extremity. This case demonstrates the importance of thorough follow-up on images ordered, including the ordering clinicians viewing the images themselves.
PubMed: 38205223
DOI: 10.1016/j.jcm.2023.07.003 -
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 -
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 -
The Malaysian Journal of Pathology Aug 2023Hepatocellular carcinoma is the most common primary liver malignancy, and sarcomatoid hepatocellular carcinoma is a rare malignancy containing both carcinomatous and...
INTRODUCTION
Hepatocellular carcinoma is the most common primary liver malignancy, and sarcomatoid hepatocellular carcinoma is a rare malignancy containing both carcinomatous and sarcomatous components.
CASE REPORT
We report a 64-year-old male patient treated with open right trisectionectomy for a 16cm right hemiliver tumour. The diagnosis of sarcomatoid hepatocellular carcinoma was confirmed on histology. Five months after hepatic resection, patient had symptoms suggestive of Horner's syndrome along with left sided shoulder pain, hand weakness, reduced power of the intrinsic hand muscles and reduced pain perception over the C8/T1 dermatome. Magnetic Resonance Imaging (MRI) showed a mass at the left lung apex/superior sulcus involving the left C8, T1 nerve roots, scalene muscles, and brachial plexus. The mass closely abutted the left first rib and partially encased the left subclavian artery. The patient was managed with palliative chemoradiotherapy for Pancoast syndrome.
DISCUSSION
Hepatocellular carcinoma pulmonary metastasis causing Pancoast syndrome is a rare occurrence with only four prior reports, and to the best of our knowledge, pulmonary metastasis from sarcomatoid hepatocellular carcinoma causing Pancoast syndrome is unreported. In this report, we will discuss the clinicopathological characteristics of this case which may provide insight into diagnosis and management of other sarcomatoid hepatocellular carcinoma patients.
PubMed: 37658538
DOI: No ID Found -
Journal of Clinical Rheumatology :... Sep 2023
Topics: Humans; Osteoarthropathy, Secondary Hypertrophic; Pancoast Syndrome; Osteoarthropathy, Primary Hypertrophic
PubMed: 37370203
DOI: 10.1097/RHU.0000000000001995 -
Thoracic Cancer Jun 2023Hepatocellular carcinoma (HCC) is a common cancer and is frequently diagnosed at a late and unresectable stage with limited effective treatment options. Here, we present...
Hepatocellular carcinoma (HCC) is a common cancer and is frequently diagnosed at a late and unresectable stage with limited effective treatment options. Here, we present the fifth reported case of a 77 year-old male with metastatic HCC presenting as a symptomatic superior sulcus lung tumor and discuss the genomic profile of this rare presentation of HCC for the first time, which included multiple classic mutations in HCC such as TERT, TP53, and WNT/β-catenin signaling as well as in the DNA repair gene ATM. The patient was treated with palliative radiotherapy to the Pancoast tumor followed by atezolizumab plus bevacizumab and passed away 6 months after diagnosis. This rare case highlights the need for effective treatment in aggressive and unresectable HCC and the utility of early genomic studies to allow for targeted therapy such as poly (ADP-ribose) polymerase (PARP)-inhibitors.
Topics: Male; Humans; Aged; Carcinoma, Hepatocellular; Liver Neoplasms; Pancoast Syndrome; Treatment Outcome; Genomics
PubMed: 37160416
DOI: 10.1111/1759-7714.14923