Pancoast Tumour

Vinod NaneriaGirish Yeotikar

Arjun WadhwaniChoithram Hospital & Research Centre,

Indore, India

Eyes see only those things which mind knows.

60 Yrs Male 65 Yrs Male

Case One Case Two

Clinical presentations

• Radicular pain Rt arm.• Severe parasthesia.• Disturbing sleep.• Non – DM, Non HT.• Chronic smoker.• Neck movements

limited & painful.• Shoulder normal.• No neurological deficit.

• Radicular pain Lt arm.• Severe parasthesia.• Disturbing sleep.• Non – DM, Non HT.• Chronic smoker• Neck movements

limited & painful• Shoulder normal• No neurological deficit.

Case one Case Two

Clinical diagnosis: Cervical Spondylosis!

Typical cervical spine MRI of case two

Missed the target by miles!

Have a look again

First Rib

Second Rib

Third Rib

First Rib

Third Rib

Second Rib on Right side missing

Case one

Mass Right apex eroding 2nd rib and vertebra

Opacity on left upper lobe

Case two

Pancoast Tumour

Pancoast tumours are named for Henry Pancoast, a US radiologist, who described them in 1924 and 1932. It is also called a pulmonary sulcus tumour or superior sulcus tumour.It is a tumour 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. Most Pancoast tumors are non-small cell cancers.

Pancoast Tumour• A Pancoast tumour is an apical tumour 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 superior thoracic aperture. The patient's smoking history, rapid onset of clinical signs and symptoms and pleuritic pain can suggest an apical tumour.

Often confused with clinical and radiological picture of Cervical Spondylosis in early stages.

Typical Chest X-ray

DISCLAIMER Information contained and transmitted by this presentation is

based on personal experience and collection of cases at Choithram Hospital & Research centre, Indore, India, during last 32 years. It is intended for use only by the students of orthopaedic surgery. Views and opinion expressed in this presentation are personal. Depending upon the x-rays and clinical presentations viewers can make their own opinion. For any confusion please contact the sole author for clarification. Every body is allowed to copy or download and use the material best suited to him. I am not responsible for any controversies arise out of this presentation. There is no direct or indirect involvement of finances in preparation of this presentation. For any correction or suggestion please contact naneria@yahoo.com