Pancoast Tumor (cont.)
Pancoast Tumor Symptoms
Although a Pancoast tumor is a lung tumor, it rarely causes symptoms that are typically related to the lungs (eg, 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 pinky 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 paresthesia (a sensation of pricking, tingling, or creeping on the skin).
If the tumor 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 characterized 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 persons with Pancoast tumor, compression of the spinal cord and paraplegia (paralysis of the lower half of the body with involvement of both legs) develop when the tumor extends into the intervertebral foramina (opening between 2 vertebrae).
Shreekanth V Karwande, MBBS
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