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American Journal of Hematology Nov 2020
Topics: Diagnosis, Differential; Humans; Leukemia, Plasma Cell; Magnetic Resonance Imaging; Male; Middle Aged; Pancoast Syndrome; Tomography, X-Ray Computed
PubMed: 32833248
DOI: 10.1002/ajh.25977 -
Agri : Agri (Algoloji) Dernegi'nin... Apr 2020A Pancoast or superior sulcus tumor is a rare, bronchogenic carcinoma. In the early period, shoulder pain is the most common symptom. In this case, the patient had...
A Pancoast or superior sulcus tumor is a rare, bronchogenic carcinoma. In the early period, shoulder pain is the most common symptom. In this case, the patient had presented with complaints of shoulder and arm pain at other outpatient clinics and was examined primarily for musculoskeletal causes and radiculopathy. The patient had no complaints of facial symptoms and Horner's syndrome signs, such as anhidrosis of the face and neck region, were not noticed. Advanced imaging of a patient with preganglionic Horner's syndrome is important. Fewer than 50% of patients with a Pancoast tumor have a resectable lesion at the first diagnosis. Diagnosis is often delayed or there may be a misdiagnosis because musculoskeletal disorders are the focus and there are few lung-related complaints. A detailed examination and anamnesis is very important in patients with arm and shoulder pain.
Topics: Adult; Diagnosis, Differential; Horner Syndrome; Humans; Male; Pancoast Syndrome; Shoulder Pain
PubMed: 32297960
DOI: 10.5505/agri.2018.14892 -
International Journal of Surgery Case... 2020Superior sulcus tumors (SSTs) are a wide range of tumors invading a section of the apical chest wall called the thoracic inlet. The unique characteristics of SSTs lie in...
INTRODUCTION
Superior sulcus tumors (SSTs) are a wide range of tumors invading a section of the apical chest wall called the thoracic inlet. The unique characteristics of SSTs lie in the anatomy of the region where these tumors occur. For this reason, a surgical approach to treating these tumors is technically demanding, and complete resection may be difficult to accomplish.
CASE PRESENTATION
A 71-year-old Japanese man presented at our hospital due to left anterior chest pain and an abnormal chest CT scan showing a 40 × 33 × 30-mm tumor located in the left anterior apex of the thoracic inlet. This tumor had invaded the first and second rib and was located near the subclavian vein. There was no significant distant metastasis. Therefore, we performed surgical resection. The surgical procedure included three steps. First, we performed VATS observation via the left thoracic cavity. Second, via the transmanubrial approach, we obtained tumor-free margins of the anterior cervical structures. Third, through VATS in the left lateral decubitus position, we performed left upper lobectomy and mediastinal lymph node dissection. This surgery was successful, with no postoperative complications.
DISUCUSSION
This surgical approach was effective and safe for treating a superior sulcus tumor located the anterior apex of the thoracic inlet. Next, VATS lobectomy is minimally invasive and safe after the transmanubrial approach for managing anterior superior sulcus tumor.
CONCLUSION
We experienced a case of locally advanced superior sulcus tumor located at the anterior apex of the thoracic inlet and performed complete resection.
PubMed: 32145568
DOI: 10.1016/j.ijscr.2020.02.047 -
Cureus Nov 2019Pancoast tumors are non-small cell lung tumors, which can invade the ribs, vertebrae, sympathetic ganglia and brachial plexus. In this study, a patient with right-sided...
Pancoast tumors are non-small cell lung tumors, which can invade the ribs, vertebrae, sympathetic ganglia and brachial plexus. In this study, a patient with right-sided Pancoast tumor presented with intractable chronic pain on the right neck, upper extremity and chest wall. The chronic pain associated with Pancoast tumor, which was difficult to treat with opioids and other medications, was effectively treated with a high-thoracic erector spinae plane block (ESPB). Prolonged analgesia was provided with an ESP catheter to wean the patient from opioids. This case report provides an example where the novel interfacial ESP block can provide pain relief in challenging situations such as lung malignancies involving deeper structures and extensive areas of pain.
PubMed: 31857924
DOI: 10.7759/cureus.6092 -
Proceedings (Baylor University. Medical... Oct 2019A 74-year-old man presented to an orthopedic spine surgeon with signs and symptoms consistent with cervical radiculopathy. Investigation revealed metastasis of a...
A 74-year-old man presented to an orthopedic spine surgeon with signs and symptoms consistent with cervical radiculopathy. Investigation revealed metastasis of a Pancoast tumor to the patient's brachial plexus. A year after initial diagnosis, the patient achieved full neurological function of his left arm. Pancoast tumors are rare in the orthopedic population. Thorough physical examination, imaging, and nerve conduction studies ultimately led to the patient's diagnosis.
PubMed: 31656428
DOI: 10.1080/08998280.2019.1647737