Pancoast tumor physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overveiw
Common physical examination findings of Pancoast tumor include decreased/absent breath sounds, pallor, low-grade fever, and tachypnea. On physical examination, Pancoast tumor may present with features of lethargy, emaciation, confusion, low-grade fever, decreased sPO2, tachypnea, tachycardia, low blood pressure, decreased/absent breath sounds, bone pain, fractures (usually in the vertebrae, femur, pelvic bones, and the ribs), pallor, decreased sweating on ipsilateral side of the face, ptosis, miosis, anhydrosis, supraclavicular lymphadenopathy, cranial nerve palsies, tingling and pain along the distribution of ulnar nerve, clubbing of fingers, weakness of arms and hands, hemiplegia, paraplegia, shoulder pain, edematous swelling of the ipsilateral arm.
Physical Examination
Pancoast tumor is a subtype of lung cancer localized to the apical portion of the lung. Common physical examination findings of Pancoast tumor include decreased/absent breath sounds, pallor, low-grade fever, and tachypnea. On Physical examination pancoast tumor may present with the features including: [1][2][3][4][5][6][7]
General appearance
Patients with Pancoast tumor generally appear lethargic, emaciated, and confused.
Vital Signs
- Vital signs are generally within normal limit, but patients with severe disease may present the following vital signs:
- Low-grade fever
- Decreased sPO2
- Tachypnea
- Tachycardia
- Low blood pressure
Chest
- Decreased/absent breath sounds
Skeletal
Skin
- Pallor
- Decreased sweating on ipsilateral side of the face
HEENT
- Ptosis
- Miosis
- Anhydrosis
- Supraclavicular Lymphadenopathy
CNS
- Cranial nerve palsies
- Tingling and pain along the distribution of ulnar nerve
Extremities
- Clubbing of fingers
- Weakness of arms and hands
- Hemiplegia
- Paraplegia
- Shoulder pain
- Edematous swelling of the ipsilateral arm
References
- ↑ Degner, Lesley F.; Sloan, Jeffrey A. (1995). "Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer". Journal of Pain and Symptom Management. 10 (6): 423–431. doi:10.1016/0885-3924(95)00056-5. ISSN 0885-3924.
- ↑ Feinstein AR, Wells CK (1990). "A clinical-severity staging system for patients with lung cancer". Medicine (Baltimore). 69 (1): 1–33. PMID 2299974.
- ↑ Chute CG, Greenberg ER, Baron J, Korson R, Baker J, Yates J (1985). "Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont". Cancer. 56 (8): 2107–11. PMID 2992757.
- ↑ Hirshberg B, Biran I, Glazer M, Kramer MR (1997). "Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital". Chest. 112 (2): 440–4. PMID 9266882.
- ↑ Kuo CW, Chen YM, Chao JY, Tsai CM, Perng RP (2000). "Non-small cell lung cancer in very young and very old patients". Chest. 117 (2): 354–7. PMID 10669674.
- ↑ Lepper PM, Ott SR, Hoppe H, Schumann C, Stammberger U, Bugalho A, Frese S, Schmücking M, Blumstein NM, Diehm N, Bals R, Hamacher J (2011). "Superior vena cava syndrome in thoracic malignancies". Respir Care. 56 (5): 653–66. doi:10.4187/respcare.00947. PMID 21276318.
- ↑ Buccheri, G. (2004). "Lung cancer: clinical presentation and specialist referral time". European Respiratory Journal. 24 (6): 898–904. doi:10.1183/09031936.04.00113603. ISSN 0903-1936.