TAILIEUCHUNG - Pancoast syndrome

Pancoast tumor, or superior sulcus tumor, is a tumor of the pulmonary apex . a type of lung cancer defined primarily by its location situated at the top end of either the right or left lung. The growing tumor can cause compression of a brachiocephalic vein, subclavian artery, phrenic nerve, recurrent laryngeal nerve, vagus nerve, or, characteristically, compression of a sympathetic ganglion resulting in a range of symptoms known as Horner's syndrome. | Pancoast syndrome pancoast tumor or superior sulcus tumor is a tumor of the pulmonary apex . a type of lung cancer defined primarily by its location situated at the top end of either the right or left lung. The growing tumor can cause compression of a brachiocephalic vein subclavian artery phrenic nerve recurrent laryngeal nerve vagus nerve or characteristically compression of a sympathetic ganglion resulting in a range of symptoms known as Horner s syndrome. Symptoms Symptoms can include miosis constriction of the pupils anhidrosis lack of sweating ptosis drooping of the eyelid and in severe cases a complete Horner s syndrome. In progressive cases the brachial plexus is also affected causing pain and weakness in the muscles of the arm and hand. The tumour can also compress the right recurrent laryngeal nerve a hoarse voice and bovine cough may also occur. In superior vena cava syndrome obstruction of the superior vena cava by a tumor mass effect causes facial swelling cyanosis and dilatation of the veins of the head and neck. A pancoast tumor is an apical tumor that is typically found in conjunction with a smoking history. The clinical signs and symptoms can be confused with neurovascular compromise at the level of the thoracic outlet. The patient s smoking history rapid onset of clinical signs and symptoms and pleuritic pain can suggest an apical tumor. A pancoast tumor can give rise to both pancoast syndrome as well as Horner s syndrome. When the brachial plexus roots are involved then it will lead to Pancoast syndrome where as involvement of sympathetic fibers as they exit the cord at T1 to ascend to superior cervical ganglion will lead to Horner s syndrome. Treatment The treatment of a Pancoast lung cancer may differ from that of other types of non-small cell lung cancer. Its position and close proximity to vital structures such as nerves and spine may make surgery difficult. As a result and depending on the stage of the cancer treatment may involve .

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