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Clin Transl Radiat Oncol 2019 Feb 6;15:83-92. Epub 2019 Jan 6.

Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, TX 77030, USA.

Introduction: Target delineation variability is a significant technical impediment in multi-institutional trials which employ intensity modulated radiotherapy (IMRT), as there is a real potential for clinically meaningful variances that can impact the outcomes in clinical trials. The goal of this study is to determine the variability of target delineation among participants from different institutions as part of Southwest Oncology Group (SWOG) Radiotherapy Committee's multi-institutional quality assurance study in patients with Pancoast tumors as a "dry run" for trial implementation.

Methods: CT simulation scans were acquired from four patients with Pancoast tumor. Read More

Front Neurol 2019 22;10. Epub 2019 Jan 22.

Department of Neurology, Ohio State University Wexner Medical Center, Columbus, OH, United States.

Horner's syndrome is an established clinical finding unique to neoplastic brachial plexopathy. We present the case of a patient who developed Horner's syndrome as the first manifestation of neurolymphomatosis (NL) of the brachial plexus that did not have the usually associated bulky adenopathy/Pancoast syndrome phenotype. We discuss the clinical utility of Horner's syndrome with regards to brachial plexopathy of indeterminate etiology, as well as the utility of other diagnostic modalities in NL. Read More

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.

Pancoast's syndrome may be the result of neoplastic, inflammatory or infectious disease. We report an unusual case of Pancoast's syndrome in a patient with metastatic breast cancer. A 54-year-old woman, affected by metastatic breast cancer, presented for severe shoulder pain, paraesthesia and numbness in the right arm. Read More

J Mycol Med 2019 Apr 12;29(1):80-83. Epub 2018 Dec 12.

Department of Radiology, Zhejiang Hospital, 12, Lingyin road, 310013 Hangzhou, China. Electronic address:

Pulmonary mucormycosis is a rare opportunistic infection caused by Mucormycosis. This fungal infection is uncommon in immunocompetent individuals. Because of its various clinical and imaging manifestations, it is a diagnostic challenge to distinguish pulmonary mucormycosis from other pulmonary diseases, such as carcinoma. Read More

J Emerg Med 2018 09 23;55(3):399-401. Epub 2018 Jul 23.

Department of Emergency Medicine, University of California, San Diego, California.

Background: Pancoast syndrome is an uncommon complication of apical lung tumors. Symptoms include pain, brachial plexopathy, and Horner's syndrome, and are the result of extrinsic compression of tissues within the thoracic inlet. Lymphoma is a very rare etiology. Read More

Infection 2018 Oct 25;46(5):735-736. Epub 2018 Jan 25.

Department of Emergency Room and General Medicine, Ageo Central General Hospital, Ageo, Japan.

BMJ Case Rep 2017 Dec 7;2017. Epub 2017 Dec 7.

Department of Pulmonary, Critical Care and Sleep Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Here we present a case of a large pleural lipoma which presented with paresthesias of the hand. This is an unusual presentation of an uncommon tumour. Read More

BMJ Case Rep 2017 Jun 13;2017. Epub 2017 Jun 13.

Department of Internal Medicine, King Abdullah Medical City, Mecca, Saudi Arabia.

Ann Thorac Cardiovasc Surg 2017 Jun 9;23(3):161-163. Epub 2017 May 9.

Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Kashihara, Nara, Japan.

We describe our approach to resect a Pancoast tumor with thoracoscopic assistance in a partitioned incision. We used the LigaSure vessel-sealing system under thoracoscopy in chest wall resection for Pancoast tumor. This approach is of great utility: easy-to use and less invasive for Pancoast tumor resection. Read More

J Surg Oncol 2017 Aug 13;116(2):227-235. Epub 2017 Apr 13.

Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University of Vienna, Austria.

Objective: This study aims to evaluate the impact of T stage and extended surgery on the outcome of patients with Pancoast tumors after induction chemoradiation therapy.

Methods: Forty-six consecutive patients who underwent chemoradiation therapy (platin-based, 45-66 Gy) followed by surgery between 1998 and 2013 were retrospectively reviewed and analyzed.

Results: In 28 (61%) patients with T4 tumors, extended procedures (more than rib resection) were performed. Read More

3D Print Med 2017 6;3(1):14. Epub 2017 Dec 6.

1Department of Medical Imaging, The Ottawa Hospital, University of Ottawa School of Medicine, Ottawa, ON Canada.

In this work, we provide specific clinical examples to demonstrate basic practical techniques involved in image segmentation, computer-aided design, and 3D printing. A step-by-step approach using United States Food and Drug Administration cleared software is provided to enhance surgical intervention in a patient with a complex superior sulcus tumor. Furthermore, patient-specific device creation is demonstrated using dedicated computer-aided design software. Read More

Pain Med 2016 12 1;17(12):2437-2438. Epub 2016 Jun 1.

Department of Radiology, Elbistan State Hospital, Kahramanmaraş, Turkey.

Rev Mal Respir 2016 Nov 29;33(9):808-811. Epub 2016 Aug 29.

Service de pneumologie, hôpitaux de Brabois, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France.

Introduction: Rhabdoid tumours usually develop in brain and spinal cord or kidney; they are highly malignant neoplasms that typically arise in infancy and early childhood. However, rare cases of pulmonary localization have been described, particularly among young adults.

Case Report: A 26-year-old man, smoker, had a right apical lung mass associated with a Pancoast syndrome leading to haemoptysis. Read More

J Coll Physicians Surg Pak 2016 Jul;26(7):623-5

Department of Medicine, Khyber Teaching Hospital, Peshawar.

This report describes a patient who presented with pancoast syndrome, secondary to spindle cell sarcoma of the lung. A 56-year man presented with dyspnea, engorged neck veins and bilateral upper limb pitting edema. The patient also had ptosis and miosis in the right eye. Read More

Mayo Clin Proc 2016 05;91(5):e69-70

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.

J Cardiothorac Surg 2016 Apr 14;11(1):65. Epub 2016 Apr 14.

Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS (Scientific Institute for Research Hospitalization and Health Care) "Ca' Granda" General Hospital University of Milan, Via Francesco Sforza, 35, Milan, 20122, Italy.

Background: The mini-ivasive approach to superior sulcus tumors is an uncommon procedure that is still far from standardization. We describe a hybrid surgical technique to approach "en block" chest resection and pulmonary lobectomy for anterior superior sulcus tumors.

Case Presentation: A patient affected by right anterior Pancoast tumor surgically staged as cT4N0M0 (suspected anonymous vein invasion) underwent chemo-radiation induction therapy with satisfactory tumor reduction. Read More

Chin Clin Oncol 2015 Dec;4(4):41

Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Thoracic Oncology Institute Marie Lannelongue Hospital, Le Plessis Robinson, France.

Background: To update the long-term outcomes after subclavian artery (SA) resection and reconstruction during surgery for thoracic inlet (TI) cancer through the anterior transclavicular approach.

Methods: Between 1985 and 2014, 85 patients (60 men and 25 women; mean age, 52 years) underwent en bloc resection of thoracic-inlet non-small cell lung cancer (NSCLC) (n=69), sarcoma (n=11), breast carcinoma (n=3) or thyroid carcinoma (n=2) involving the SA. L-shaped transclavicular cervicothoracotomy was performed, with posterolateral thoracotomy in 18 patients or a posterior midline approach in 15 patients. Read More

Cancer Biother Radiopharm 2015 Oct 14;30(8):359-67. Epub 2015 Sep 14.

5 Department of Nuclear Medicine, Gulhane Military Medical Academy and Medical Faculty , Ankara, Turkey .

Purpose: To evaluate any potential value of 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography/computerized tomography (FDG PET/CT) in staging of patients with Pancoast tumors and to investigate the relationship between volume-based quantitative PET parameters and prognosis.

Materials And Methods: The authors retrospectively reviewed data of the 47 patients with Pancoast tumors who underwent initial staging by conventional imaging methods and FDG PET/CT. FDG-PET images were visually and quantitatively evaluated, and metabolic tumor volume (MTV), total lesion glycolysis, and maximum standardized uptake values of primary tumors were calculated. Read More

Methodist Debakey Cardiovasc J 2015 Apr-Jun;11(2):140-4

Houston Methodist DeBakey Heart& Vascular Center, Houston Methodist Hospital, Houston, Texas.

"Pancoast" tumors frequently require a multidisciplinary approach to therapy and are still associated with high morbidity and mortality. Due to their sensitive anatomic location, complex resections and chemoradiation regimens are typically required for treatment. Those with signs of aortic invasion pose an even greater challenge, given the added risks of cardiopulmonary bypass for aortic resection and interposition. Read More

Surg Today 2016 Jun 22;46(6):686-90. Epub 2015 Jul 22.

Department of General Thoracic Surgery, Sheba Medical Center, and Sackler School of Medicine, Tel-Aviv University, Ramat Gan, Israel.

Purpose: To compare the postoperative recovery of patients with superior sulcus tumors (Pancoast tumors) following conventional open surgery vs. a hybrid video-assisted and limited open approach (VALO).

Methods: The subjects of this retrospective study were 20 patients we operated on to resect a Pancoast tumor. Read More

J Thorac Dis 2014 Mar;6 Suppl 1:S180-93

1 Department of Cardiothoracic Surgery, Patras University School of Medicine, Patra, Greece ; 2 Department of Thoracic Surgery, Metaxa Cancer Hospital, Piraeus, Greece ; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece ; 4 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Internal Medicine Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece ; 7 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 8 Anesthesiology Department, University of Larisa, Larisa, Greece ; 9 Anesthesiology Department, "Saint Luke" Private Clinic of Health Excellence, Thessaloniki, Panorama, Greece.

A Pancoast tumor, also called a pulmonary sulcus tumor or superior sulcus tumor, is a tumor of the pulmonary apex. It is a type of lung cancer defined primarily by its location situated at the top end of either the right or left lung. It typically spreads to nearby tissues such as the ribs and vertebrae. Read More

Curr Probl Diagn Radiol 2014 Mar-Apr;43(2):91-8

Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.

Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Read More

Gen Thorac Cardiovasc Surg 2015 Nov 25;63(11):627-31. Epub 2014 Jan 25.

Department of Thoracic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.

The anterior transcervical-thoracic approach clearly exposes the subclavian vessels and brachial plexus. We believe that this approach is optimal when a superior sulcus tumor (SST) invades the anterior part of the thoracic inlet. However, this approach is not yet widely applied because anatomical relationships in this procedure are difficult to visualize. Read More

Pain Med 2014 Apr 8;15(4):716-8. Epub 2014 Jan 8.

Department of Endocrinology and Metabolism, Guangzhou Medical College, Guangzhou, Guangdong, China; Department of Pediatric, Shufu County People's Hospital, Kashi, Xinjiang, China.

J Thorac Dis 2013 Sep;5 Suppl 4:S342-58

Department of Cardiothoracic Surgery, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece;

Pancoast tumors account for less than 5% of all bronchogenic carcinomas. These tumors are located in the apex of the lung and involve through tissue contiguity the apical chest wall and/or the structures of the thoracic inlet. The tumors become clinically evident with the characteristic symptoms of the "Pancoast-Tobias syndrome" which includes Claude-Bernard-Horner syndrome, severe pain in the shoulder radiating toward the axilla and/or scapula and along the ulnar distribution of the upper arm, atrophy of hand and arm muscles and obstruction of the subclavian vein resulting in edema of the upper arm. Read More

Ann Indian Acad Neurol 2013 Jan;16(1):12-8

Department of Neurology, Grant Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India.

Brachial plexus injury can occur as a result of trauma, inflammation or malignancies, and associated complications. The current topic is concerned with various forms of brachial plexopathy, its clinical features, pathophysiology, imaging findings, and management. Idiopathic brachial neuritis (IBN), often preceded with antecedent events such as infection, commonly present with abruptonset painful asymmetric upper limb weakness with associated wasting around the shoulder girdle and arm muscles. Read More

Chest 2013 May;143(5 Suppl):e369S-e399S

Department of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, VA. Electronic address:

Background: This guideline updates the second edition and addresses patients with particular forms of non-small cell lung cancer that require special considerations, including Pancoast tumors, T4 N0,1 M0 tumors, additional nodules in the same lobe (T3), ipsilateral different lobe (T4) or contralateral lung (M1a), synchronous and metachronous second primary lung cancers, solitary brain and adrenal metastases, and chest wall involvement.

Methods: The nature of these special clinical cases is such that in most cases, meta-analyses or large prospective studies of patients are not available. To ensure that these guidelines were supported by the most current data available, publications appropriate to the topics covered in this article were obtained by performing a literature search of the MEDLINE computerized database. Read More

Case Rep Radiol 2013 31;2013:479120. Epub 2013 Mar 31.

Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.

We report imaging techniques in the definition of the therapeutic planning of a 65-year-old man with a diagnosis of Pancoast tumor. Computed Tomography has a pivotal role in the assessment of nodes involvement and distant metastasis. Magnetic Resonance allows a detailed study of locoregional extension for its high soft tissue resolution. Read More

Acta Neurochir (Wien) 2013 Jul 17;155(7):1243-4. Epub 2013 Apr 17.

Eur J Orthop Surg Traumatol 2013 Apr 4;23(3):273-9. Epub 2012 Apr 4.

Department of Radiotherapy, Fukuroi Municipal Hospital, 2515-1 Kunou, Fukuroi, Shizuoka, Japan.

The value of cervical spine or shoulder radiography has been established for the detection of Pancoast tumors. However, for the detection of lung cancers other than Pancoast tumors, the value of these skeletal radiographies has not been assessed. The aim of our study was to determine how many patients first presented to orthopedists with manifestations of lung cancer on skeletal radiographs and to present several cases for illustration. Read More

Turk Neurosurg 2013 ;23(1):81-7

President of the Turkish Academy of Sciences, Emeritus, Ankara University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey.

Aim: Lung cancer is the leading cause of cancer-related mortality worldwide. Pain is a common problem in these patients, yet inadequate or dissatisfactory management is prevalent.

Material And Methods: Between 1987 and 2012, 224 patients with intractable pain were treated with computerized tomography (CT)- guided cordotomy. Read More

Pneumologie 2012 Nov 25;66(11):666-8. Epub 2012 Sep 25.

Medizinische Klinik I, Universitätsklinikum RWTH Aachen.

BMJ Case Rep 2012 Jun 12;2012. Epub 2012 Jun 12.

Department of Rheumatology, East and North Hertfordshire NHS Trust, Stevenage, UK.

Interact Cardiovasc Thorac Surg 2012 Jun 8;14(6):906-8. Epub 2012 Mar 8.

Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University of Medicine, Sapporo, Japan.

There are various surgical approaches to superior sulcus tumours according to the location of the tumour. The chief difficulties in the operation are broadening of the operative field and adhesiolysis. This study presents the case of surgical treatment of superior sulcus tumour following chemoradiation therapy with dense pleural adhesion due to a history of graft replacement of the descending thoracic aorta. Read More

J Rehabil Med 2012 Feb;44(2):181-3

Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Gülhane Military Medical Academy, Ankara, Turkey.

Objective: We report here a case of neoplastic brachial plexopathy detected by musculoskeletal ultrasonography in a patient with chronic cervicobrachialgia.

Methods/results: A 71-year-old man presented at Gülhane Military Medical Academy, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey with a one-year history of cervicobrachial pain radiating to the left arm and numbness in the medial aspect of the left arm and hand. He could not tolerate magnetic resonance imaging because his pain was exacerbated by cervical extension. Read More

Tanaffos 2012 ;11(3):49-51

Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran ; Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.

Herein a 46 year-old man is presented with intolerable severe pain of right shoulder radiating to right arm and fourth and fifth fingers. He had a history of right upper lobectomy due to complicated tuberculosis eight years ago. Based on the findings of clinical examination and computed tomography imaging, diagnosis of Pancoast tumor of the right chest apex was confirmed. Read More

Zhonghua Jie He He Hu Xi Za Zhi 2011 Sep;34(9):663-5

Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To further understand the clinical features and the causes of misdiagnosis of pancoast cancer.

Methods: The data of 26 cases of pancoast cancer from 1999 - 2006 were collected for a retrospective review. The clinical and imaging features, and the causes underlying misdiagnosis were analyzed. Read More

Tunis Med 2011 Jul;89(7):598-603

Service de rheumatologie, Hopital Charles Nicolle, Tunis, Tunisie.

Background: Cervicobrachial neuralgia (CBN) is frequent in out patient clinic as well in general medicine as in rheumatology. Even though cervical disc degeneration and osteophytosis constitute the most frequent etiology of such a trouble, the practitioner must be aware of much more serious underlying cause.

Aim: To investigate the epidemiology, clinical features, aetiologies and paraclinical characteristics of uncommon CBN. Read More

Clin Nucl Med 2011 Aug;36(8):707-9

Université Paris 13, Service de médecine nucléaire, Hôpital Avicenne, Bobigny, France.

Isolated splenic metastasis is extremely rare. In this study, we report a case of a 52-year-old man referred for Pancoast Tobias Syndrome by which FDG PET/CT detected an isolated splenic metastasis. Diffusion-weighted MRI confirmed the isolated splenic lesion. Read More

Cent Eur Neurosurg 2011 May 4;72(2):90-8. Epub 2011 May 4.

Praxis für, periphere Neurochirurgie, Dossenheim, Germany.

Cubital tunnel syndrome (CuTS) is the second most common peripheral nerve compression syndrome. In German-speaking countries, cubital tunnel syndrome is often referred to as sulcus ulnaris syndrome (retrocondylar groove syndrome). This term is anatomically incorrect, since the site of compression comprises not only the retrocondylar groove but the cubital tunnel, which consists of 3 parts: the retrocondylar groove, partially covered by the cubital tunnel retinaculum (lig. Read More

Surg Laparosc Endosc Percutan Tech 2011 Apr;21(2):111-5

Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.

A retrospective review was performed of all patients with upper lobe non-small cell lung cancers to assess the use of thoracoscopy in determining chest wall invasion in patients with lung cancers abutting the first rib, but without overt radiographic invasion. Of the 12 patients with tumors abutting the first rib without overt radiographic invasion, thoracoscopy was able to correctly determine chest wall invasion in 8 patients. There was no significant morbidity related to thoracoscopy. Read More

Ann Emerg Med 2011 Mar;57(3):203, 212

Lehigh Valley Health Network, Bethlehem, PA, USA.

Sao Paulo Med J 2010 Jul;128(4):239-43

Department of Nuclear Medicine, Golestan University of Medical Sciences, Gorgan, Iran.

Context: Non-small cell lung carcinomas (NSCLCs) of the superior sulcus are considered to be the most challenging type of malignant thoracic disease. In this disease, neoplasms originating mostly from the extreme apex of the lung expand to the chest wall and thoracic inlet structures. Multiple imaging procedures have been applied to identify tumors and to stage and predict tumor resectability in surgical operations. Read More

Ther Umsch 2010 Dec;67(12):605-7

Klinik für Pneumologie, UniversitätsSpital Zürich, Zürich.

A 37-years old patient of south Indian origin presented with pain in his right scapular region radiating to the right arm, numbness and muscular weakness of the fourth and fifth finger. Computed tomography (CT) revealed a mass at the right pleural dome with arrosion of the first rib (Pancoast presentation), an osteolytic process in the fourth rib and in the right hip. All three lesions had a high FDG uptake in the PET/CT suggestive for lung cancer metastases in this smoker. Read More

Ann Thorac Surg 2010 Dec;90(6):2033-5

Department of Surgery, Division of Cardiothoracic Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.

Non-small cell pulmonary carcinomas represent the majority of tumors located in the superior sulcus. However, only 5% of all non-small cell pulmonary carcinomas present in the superior sulcus. Other causes of superior sulcus tumors include metastatic tumors, hematologic malignancies, infectious causes, and amyloid nodules, as well as other lesions. Read More

J Assoc Physicians India 2010 Apr;58:232

Department of Medicine, LTM Medical College and LTMG Hospital, Sion, Mumbai 400022.

Thorax 2011 Jan 7;66(1):89-90. Epub 2010 Sep 7.

Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.

J Clin Oncol 2010 Jun 12;28(16):e254-6. Epub 2010 Apr 12.

Department of Medicine, Roswell Park Cancer Institute, University of Buffalo, NY, USA.

Kyobu Geka 2010 Jan;63(1):35-40

Department of Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Japan.

A 59-year old man complaining of right shoulder pain was diagnosed with Pancoast tumor. Chest computed tomography (CT) scan showed a right superior sulcus tumor, 5.8 cm in diameter, invading the middle-posterior compartment of thoracic inlet. Read More

Tidsskr Nor Laegeforen 2009 Dec;129(24):2613-5

Kreftklinikken, Oslo universitetssykehus, Radiumhospitalet, 0310 Oslo, Norway.

A 63-year-old man was admitted to the emergency room with chest pain. He had experienced a painful, tingling sensation in the right arm for the last three months, as well as pain in the right scapula. ECG and standard blood samples were normal. Read More