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J Brachial Plex Peripher Nerve Inj 2015; 10(01): e53-e56
DOI: 10.1055/s-0035-1551654
Case Report
Georg Thieme Verlag KG Stuttgart · New York

A Case of Pancoast Tumor with Unusual Presentation

Bernadette Calabek
1   Department of Neurology, Kaiser Franz Josef-Hospital, Ludwig Boltzmann-Institute of Neurooncology, Vienna, Austria
,
Stefan Meng
2   Department of Radiology, Kaiser Franz Josef-Hospital, Vienna, Austria
,
Sabine Pollanz
1   Department of Neurology, Kaiser Franz Josef-Hospital, Ludwig Boltzmann-Institute of Neurooncology, Vienna, Austria
,
Walter Klepetko
3   Department of Thoracic Surgery, University Hospital of Vienna, Vienna, Austria
,
Konrad Hoetzenecker
3   Department of Thoracic Surgery, University Hospital of Vienna, Vienna, Austria
,
Felicitas Oberndorfer
4   Clinical Institute of Pathology, University Hospital of Vienna, Vienna, Austria
,
Wolfgang Grisold
1   Department of Neurology, Kaiser Franz Josef-Hospital, Ludwig Boltzmann-Institute of Neurooncology, Vienna, Austria
› Author Affiliations
Further Information

Publication History

03 August 2014

24 March 2015

Publication Date:
02 May 2015 (online)

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Abstract

Introduction The Pancoast syndrome (PS) has been termed after Henry Pancoast. Its neurologic core symptoms include pain, radicular sensory and motor syndromes, and Horner syndrome. A PS is often the presenting sign of lung cancer and bears a grim prognosis.

Methods This case report describes an atypical onset of a lung tumor causing a PS. Electrophysiological examination was not conclusive. The diagnosis was confirmed by MRI, CT scan, and biopsy. The intervention consisted of preoperative chemo- and radiotherapy and was followed by an extensive surgical approach with histologically confirmed perineural invasion of the brachial plexus.

Results The postoperative period was dominated by neuropathic pain. Despite considerable loss of distal sensorimotor function of the right hand, the patient uses the extremity and has returned to professional life.

Discussion This observation triggered by the advances in general oncology and surgery also demonstrates the management of a lesion of the peripheral nervous system caused by cancer.

Keywords

brachial plexus - lung cancer - nerve infiltration - outcome - Pancoast tumor - surgical resection
 

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