Deciphering the enigmatic symptoms of Pancoast tumors: Navigating the complex landscape of pain management—A case report

• Published in: Radiology case reports 2024-05, Vol.19 (5), p.1810-1814
• Main Authors: Kočan, Ladislav, Rapčan, Róbert, Griger, Martin, Rapčanová, Simona, Kantárová, Daniela, Török, Pavol, Vašková, Janka
• Format: Article
• Language: English
• Subjects: Cervical lymphadenopathy; Cervical spinal lysis; Epicondylitis; Osteolysis; Pain; Pancoast tumor
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2024.01.091

Pancoast tumors, also known as superior sulcus tumors, encompass a diverse spectrum of neoplasms that infiltrate the apex of the chest wall, yielding distinctive clinical presentations. One of the earliest signs of tumor growth is pain radiating to the upper limb, stemming from peripheral nerve involvement, which can mimic joint pain or spinal radicular irritation. In this case report, we present the clinical history of a 64-year-old female smoker who had previously been recommended for orthopedic elbow surgery due to epicondylitis. Subsequent to the development of additional symptoms and rigorous investigation, a Pancoast tumor was diagnosed. Furthermore, we discuss the characteristic treatment modalities available for Pancoast tumors, including pharmacological pain management and interventional strategies such as spinal cordotomy and spinal alcoholysis. This case underscores the significance of recognizing atypical presentations and emphasizes the importance of comprehensive evaluation in the diagnosis and management of Pancoast tumors.