Pancoast tumor CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]

Overview

CT scan is diagnostic of Pancoast tumor. CT scan has a limited ability to determine the extent of invasion of the primary tumor into adjoining structures when compared to MRI scan. Findings on CT scan of the chest suggestive of Pancoast tumor include invasion of brachial plexus, invasion of the chest wall and/or mediastinum, the extension of the tumor into vena cava, trachea and esophagus, subclavian-vessel involvement is assessed by contrast CT scanning.

CT Scan

• CT scan is diagnostic of Pancoast tumor, a subtype of lung cancer located at the lung apex.
• CT scan has a limited ability to determine the extent of invasion of the primary tumor into adjoining structures when compared to MRI scan.
• Chest CT scan is the modality of choice in the diagnosis of lung cancer. Findings on CT scan of the chest suggestive of Pancoast tumor include:
  • Invasion of brachial plexus
  • Invasion of chest wall and/or mediastinum
  • Extension of the tumor into vena cava, trachea and esophagus.
  • Subclavian vessel involvement is assessed by contrast CT scanning.

Irregular shaped ill defined right apical lung mass is seen invading the right aspect of D2 vertebral body with its transverse process, costovertebral junction and adjacent rib. superiorly it extends to the root of the neck.Case courtesy of Dr Ahmed Abd Rabou, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/27303">rID: 27303</a>

The chest CT scan confirms that the tumor involves the superior sulcus.Case courtesy of Dr David Cuete, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/23281">rID: 23281</a>

Superior sulcus tumor. Axial (A) and coronal (B) CT scans show a large mass in the apex of the right lung causing destruction of the first and second ribs (arrows) with erosion of the right half of the vertebral body (arrowheads) suggestive of a superior sulcus tumor, via<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419420/figure/F16/>

References