Pancoast tumor pathophysiology

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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

Pathophysiology

• Pancoast tumor is the type of lung cancer that is associated with invasion of the apical chest wall. The location of Pancoast tumor in the superior sulcus results in an invasion of adjacent structures and results in the characteristic clinical presentation.
• The progression of Pancoast tumor usually involves spread across the pleural apex to invade the following structures by direct extension:
  • Lymphatic vessels in the endothoracic fascia
  • Intercoastal nerves
  • Lower roots of brachial plexus
  • Stellate ganglion
  • Sympathetic chain
  • The first, second, or third rib
  • First or second thoracic vertebra bodies or intervertebral foramina
  • Extension to the spinal cord can result in cord compression
  • Subclavian artery
  • Subclavian vein

• The development of Pancoast syndrome is the result of tumors in the superior pulmonary sulcus is characterized by pain along ulnar nerve distribution and Horner syndrome.

References