Pancoast tumour presenting as shoulder pain with Horner’s syndrome

A 54-year-old man presented to the emergency department with a 4-week history of right shoulder pain radiating down his arm, with some associated sensory loss. Further questioning and examination in the department revealed a classical Horner’s syndrome; miosis, partial ptosis and hemifacial anhidros...

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Bibliographic Details
Published in:BMJ case reports 2019-01, Vol.12 (1), p.bcr-2018-227873
Main Authors: Shanmugathas, Nimlan, Rajwani, Kapil Mohan, Dev, Shumontha
Format: Article
Language:English
Subjects:
Brain research
Case reports
Emergency Service, Hospital
Horner Syndrome - complications
Horner Syndrome - diagnosis
Humans
Lung cancer
Lung Neoplasms - complications
Lung Neoplasms - diagnosis
Lung Neoplasms - pathology
Male
Medical imaging
Middle Aged
Pain
Pancoast Syndrome - complications
Pancoast Syndrome - diagnosis
Pancoast Syndrome - pathology
Positron Emission Tomography Computed Tomography
Shoulder
Shoulder Pain - diagnostic imaging
Shoulder Pain - etiology
Tomography
Tomography, X-Ray Computed
Tumors
Unusual Association of Diseases/Symptoms
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Summary:A 54-year-old man presented to the emergency department with a 4-week history of right shoulder pain radiating down his arm, with some associated sensory loss. Further questioning and examination in the department revealed a classical Horner’s syndrome; miosis, partial ptosis and hemifacial anhidrosis. An initial chest X-ray was deemed to be unremarkable; however, further review by a radiologist noted asymmetrical right apical thickening. A subsequent high-resolution CT scan of the chest revealed a right-sided Pancoast tumour. This case highlights the importance of a thorough history and examination in identifying a rare cause of shoulder and/or back pain.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-227873