Pancoast tumor MRI

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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

MRI is helpful in the diagnosis of Pancoast tumor. MRI offers greater detail in the evaluation of chest wall invasion, examination of vascular structures and brachial plexus involvement and resectability of the tumor.

MRI

• MRI is helpful in the diagnosis of Pancoast tumor.
• MRI offers greater detail in the evaluation of chest wall invasion, examination of vascular structures and brachial plexus involvement and resectability of the tumor.
• Findings on MRI suggestive of Pancoast tumor include:
  • Opacity at the apex of the lung or in the superior sulcus area.
  • Spread of the tumor can result in rib invasion that is observed as bone destruction of posterior ribs.
  • Vertebral body infiltration
  • Enlargement of the mediastinum
  • Invasion of brachial plexus
  • Invasion of chest wall and/or mediastinum
  • Extension of the tumor into vena cava, trachea and esophagus.

MRI of the upper chest on the right demonstrates a large mass centred in the apex of the right lung. Direct extension though the pleura and into the adjacent chest wall is seen, without obvious involvement of the brachial plexus (best demonstrated on sagittal T1). Case courtesy of A.Prof Frank Gaillard, rID: 7137