Pancoast tumor is a special type of lung cancer, which grows from the top part of lung causing special symptoms due to local compression of neighboring anatomical areas by the tumor mass.
In the vicinity of the upper lung lobe there are blood vessels supplying the upper limb and the cervical sympathetic nerve system. This nerve system belongs to the autonomic nervous system, which is a network of nerve fibers and nuclei that affect body processes independently on our will. Cervical sympathetic system is important in controlling the width of the corresponding pupil. The oppression of blood vessels and nerves that supply the upper limb may manifest by unpleasant pain radiating from the back to the upper extremity on the side of the tumor and this may be accompanied with Raynaud’s phenomenon (whitening of fingers). Disruption of the cervical sympathetic system causes emergence of the so-called Horner's syndrome in the corresponding eye – pupil constriction (miosis), drooping of the upper eyelid (ptosis) and posterior displacement of the eyeball in the orbit (enophthalmos).
Scheme - Pancoast tumor
The lung cancer may be found by simple chest X-ray, but the diagnosis should be confirmed by computed tomography, which can also evaluate the size and extent of the tumor. Other possible investigative method is the bronchoscopy, which has a chance to obtain a sample of the tumor tissue for histological examination or at least some cytologic samples.
The therapeutic approach is generally similar to other lung tumors. However, due to the close anatomical relationship to other local anatomical structures, the operability of this tumor is usually unsatisfactory.