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Pancoast tumor

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Smoker. Cough and shortness of breath.

Patient Data

Age: 45 years
Gender: Male
x-ray

7 cm mass in the medial aspect of the right lung apex abutting the mediastinum.

Left lung clear.

Back pain at T4/T5. Reduced...

mri

Back pain at T4/T5. Reduced sensation T5 down.

7 cm right upper lobe soft tissue mass infiltrating the right posterior chest wall and the paravertebral region. Soft tissue is infiltrating the right T2/3 foramen and encroaching into the spinal canal with associated canal stenosis, CSF effacement, and canal compression.

Associated infiltration of the T2 and T3 vertebral bodies and adjacent ribs.

Multiple enhancing lesions in the right cerebellar hemisphere in keeping with metastases.

Left supraclavicular fossa and right hilar adenopathy.

ct

Left SCF adenopathy. Right hilar adenopathy.

6.8 cm infiltrating right posterior chest wall/paravertebral soft tissue mass with destruction of the T3/4 vertebral bodies and the 3rd/4th right ribs with canal encroachment/cord compression.

 

Case Discussion

Advanced lung cancer at presentation with extension spinal infiltration of a Pancoast tumor.

The patient was referred for palliative radiotherapy.

 

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