Pancoast tumour

Pancoast tumours are a form of lung cancer with the tumour forming at the top of the lung.
Around 1 in 20 cases of lung cancer are Pancoast tumours.
Pancoast tumours are named after the American doctor called Professor Henry Pancoast.

Pancoast tumours spreading

Pancoast tumours may affect other parts of the body:

Lymphatics (small, thin vessels that carry lymph fluid through the body)

Lower roots of the brachial plexus (a complex network of nerves that is formed chiefly
by the lower four cervical [neck] nerves and the first thoracic [chest] nerve)

Intercostal nerves (nerves that lie between a pair of adjacent ribs)

Stellate ganglion (a mass of nerve tissue containing nerve cells that form an enlargement
on a nerve or on two or more nerves at their point of junction or separation)

Sympathetic chain (either of the pair of ganglionated lengthwise cords of the sympathetic
nervous system that are situated on each side of the spinal column)

Adjacent ribs

Vertebrae.

Carcinomas ( cancerous tumours) in the superior pulmonary sulcus produce the Pancoast
syndrome, which is characterised by pain in the shoulder and along the inner side of the
arm and hand. Pancoast tumours tend to spread to the tissue surrounding them in the early
stage of the disease. As long as the cancer has not metastasised (spread) and involved the
regional lymph nodes (small, bean-shaped structures found throughout the body), these
tumours can be successfully treated.

Pancoast tumour causes

The risk factors for almost all lung cancers are similar. These include:

Smoking

Secondary smoke exposure

Prolonged asbestos exposure

Exposure to industrial elements (e.g. gold, nickel).

Pancoast tumour symptoms

Although a Pancoast tumour is a lung tumour, it rarely causes symptoms that are typically related
to the lungs (e.g. cough, chest pain).
The initial symptom is pain in the shoulder, inner part of the scapula (large, triangular, flattened
bone that lies over the ribs on the back), or both.
The pain may later extend to the inner side of the arm, elbow and the little and ring fingers.
The associated pain is severe and constant, often requiring narcotic pain medications for relief.
The affected person usually needs to support the elbow of the affected arm in the opposite hand
to ease the tension on the shoulder and upper arm.
The hand, arm and forearm may weaken, atrophy (degenerate or shrink from disuse) or develop
paraesthesia (a sensation of pricking, tingling or creeping on the skin).
If the tumour extends to the sympathetic chain (a series of ganglia [masses of nerve cells] that
run parallel to the vertebrae) and stellate ganglion, Horner syndrome may develop on the face
and hand of one side of the body. Horner syndrome is characterised by drooping eyelids (ptosis),
absence of sweating (anhidrosis), sinking of the eyeball (enophthalmos), and excessive smallness
or contraction of the pupil of the eye (miosis).
In as many as 10%-25% of people with Pancoast tumour, compression of the spinal cord and
paraplegia (paralysis of the lower half of the body with involvement of both legs) develop when
the tumour extends into the intervertebral foramina (opening between two vertebrae).

Pancoast Tumor Causes

The risk factors for almost all lung cancers are similar. These include the following:

Smoking

Secondary smoke exposure

Prolonged asbestos exposure

Exposure to industrial elements (eg, gold, nickel)