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Pancoast Tumor

Pancoast Tumor is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Pancoast tumors, or superior sulcus tumors, refer to a unique subset of lung carcinomas.
  • These bronchogenic carcinomas are characteristically located in the apex of the lung and invade through contiguous chest wall structure; invasion and classic symptoms are required for definitive diagnosis (1).
  • They demonstrate extrathoracic extension. Invasion may include nearby lymphatics, ribs or periosteum, vertebral bodies, brachial plexus nerve roots, upper sympathetic chain, and stellate ganglion, as well as the subclavian artery and vein (2).

Epidemiology

These tumors represent 3–5% of all lung cancers. The tumor demonstrates a male preponderance and an average age of presentation during the 6th decade of life. The strongest risk factor associated with development is cigarette smoking (3).

Etiology and Pathophysiology

They most frequently present as non–small cell lung cancer (NSCLC). The most common histologic subtype is adenocarcinoma (50–66% of cases), followed by squamous cell and large cell carcinomas. Infrequently, small cell carcinomas may be present in up to 5% of cases (2).

Risk Factors

  • Tobacco use
  • Secondhand smoke
  • Radiation exposure
  • Occupational exposures including asbestos, chromium, nickel, beryllium, arsenic, soot, or tar
  • Industrial air pollution
  • Family history of lung cancer
  • HIV infection

General Prevention

Avoidance of risk factors

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Citation

Stephens, Mark B., et al., editors. "Pancoast Tumor." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816038/all/Pancoast_Tumor.
Pancoast Tumor. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816038/all/Pancoast_Tumor. Accessed April 24, 2019.
Pancoast Tumor. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816038/all/Pancoast_Tumor
Pancoast Tumor [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 24]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816038/all/Pancoast_Tumor.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pancoast Tumor ID - 816038 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816038/all/Pancoast_Tumor PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -