Pancoast tumor history and symptoms

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

The hallmark of Pancoast tumor is lung cancer located in the apex of the lung. A positive history of shoulder pain and atrophy of hand musculature, Horner’s syndrome and forearm edema is suggestive of Pancoast Syndrome. The most common symptoms of Pancoast tumor include cough, hemoptysis, dyspnea, chest pain, lack of appetite, weight loss, fatigue. Symptoms of Pancoast’s syndrome resulting from Pancoast tumor include shoulder pain along the vertebral border of the scapula, Horner’s syndrome, and weakness of hand muscles. Less common symptoms of Pancoast’s syndrome include paraplegia.

• The hallmark of Pancoast tumor is lung cancer located in the apex of the lung. A positive history of shoulder pain and atrophy of hand musculature, Horner’s syndrome and forearm edema is suggestive of Pancoast’s syndrome.^[1][2]

• The most common symptoms of Pancoast tumor include:^{[1][2][3][4][5]}
  • Cough
  • Hemoptysis
  • Dyspnea
  • Chest pain
  • Lack of appetite
  • Weight loss
  • Fatigue
• Symptoms of Pancoast’s syndrome resulting from Pancoast tumor include:
  • Shoulder pain along the vertebral border of scapula
  • Horner’s syndrome
  • Weakness of hand muscles
• Less common symptoms of Pancoast’s syndrome include:
  • Paraplegia

Paraneoplastic Syndromes

• Various paraneoplastic phenomena can arise in the setting of lung cancer:^[6][7]

• Endocrine

• SIADH causing hyponatraemia: Small cell lung cancer
• ACTH secretion (Cushing syndrome): Carcinoid tumor and small cell lung cancer
• Parathyroid Hormone-Related Peptide (PTHrP) causing hypercalcaemia: Squamous cell carcinoma of the lung
• Carcinoid syndrome
• Gynaecomastia

• Neurological

• Polyneuropathy
• Myelopathy
• Cerebellar degeneration
• Lambert-Eaton myasthenic syndrome

• Other

• Finger clubbing
• Hypertrophic pulmonary osteoarthropathy (HPOA): Squamous cell carcinoma of the lung
• Nephrotic syndrome
• Polymyositis
• Dermatomyositis
• Eosinophilia
• Acanthosis nigricans
• Thrombophlebitis: Adenocarcinoma of the lung

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