Pancoast tumour


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pancoast tumour, DD of cervical spondylosis,

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Pancoast tumour

  1. 1. Pancoast Tumour Vinod Naneria Girish Yeotikar Arjun WadhwaniChoithram Hospital & Research Centre, Indore, India
  2. 2. Eyes see only those things which mind knows.
  3. 3. 60 Yrs Male 65 Yrs MaleCase One Case Two
  4. 4. Clinical presentations Case one Case Two• Radicular pain Rt arm. • Radicular pain Lt arm.• Severe parasthesia. • Severe parasthesia.• Disturbing sleep. • Disturbing sleep.• Non – DM, Non HT. • Non – DM, Non HT.• Chronic smoker. • Chronic smoker• Neck movements • Neck movements limited & painful. limited & painful• Shoulder normal. • Shoulder normal• No neurological deficit. • No neurological deficit. Clinical diagnosis: Cervical Spondylosis!
  5. 5. Typical cervical spine MRI of case two
  6. 6. Missed the target by miles!Have a look again
  7. 7. Second Rib on Right side missing Second Rib Third Rib Third Rib First Rib First Rib Case one
  8. 8. Mass Right apex eroding 2nd rib and vertebra
  9. 9. Opacity on left upper lobeCase two
  10. 10. Pancoast TumourPancoast tumours are named for Henry Pancoast,a US radiologist, who described them in 1924 and1932. It is also called a pulmonary sulcus tumouror superior sulcus tumour.It is a tumour of the pulmonary apex. It is a typeof lung cancer defined primarily by its locationsituated at the top end of either the right or leftlung. It typically spreads to nearby tissues such asthe ribs and vertebrae. Most Pancoast tumors arenon-small cell cancers.
  11. 11. Pancoast Tumour• A Pancoast tumour is an apical tumour that is typically found in conjunction with a smoking history. The clinical signs and symptoms can be confused with neurovascular compromise at the level of the superior thoracic aperture. The patients smoking history, rapid onset of clinical signs and symptoms and pleuritic pain can suggest an apical tumour. Often confused with clinical and radiological picture of Cervical Spondylosis in early stages.
  12. 12. Typical Chest X-ray
  13. 13. DISCLAIMERInformation contained and transmitted by this presentation isbased on personal experience and collection of cases atChoithram Hospital & Research centre, Indore, India, duringlast 32 years. It is intended for use only by the students oforthopaedic surgery. Views and opinion expressed in thispresentation are personal. Depending upon the x-rays andclinical presentations viewers can make their own opinion.For any confusion please contact the sole author forclarification. Every body is allowed to copy or download anduse the material best suited to him. I am not responsible forany controversies arise out of this presentation. There is nodirect or indirect involvement of finances in preparation ofthis presentation. For any correction or suggestion pleasecontact