Pancoast Syndrome

Excerpt

Superior pulmonary sulcus tumors or Pancoast tumors arise from the apical pleuro-pulmonary groove superior to the first rib. When these tumors involve the surrounding structures such as the brachial plexus, cervical paravertebral sympathetic nervous system, and stellate ganglion, they cause a group of signs and symptoms collectively called Pancoast syndrome. This is characterized by the ipsilateral shoulder and arm pain, paresthesias, paresis, and atrophy of the thenar muscles of the hand, and Horners syndrome (ptosis, miosis, and anhidrosis). However, the Pancoast syndrome should be differentiated from the Pancoast tumor. The most common cause of the syndrome is primary bronchogenic carcinoma. The Pancoast syndrome is characterized by radiating parascapular pain, the hand's intrinsic muscles atrophy, and the presence of a density at the apex of the lung with localized destruction of ribs and vertebrae.