PANCOAST TUMOUR WITH SPINE RESECTION - CASE REPORT

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Spine Surgery

Background:

• Pancoast tumors, arising in the thoracic inlet, represent less than 5% of lung cancers.
• Spinal invasion historically rendered Pancoast tumors unresectable and fatal.
• Advancements in spine surgery now permit en bloc resection, including vertebral segments.

Observation:

• A 66-year-old male with squamous cell carcinoma of the lung (Pancoast tumor) underwent induction chemoradiotherapy.
• A successful en bloc resection was performed, encompassing the left upper lobe, three ribs, and the D2 vertebral body.
• The surgical approach utilized a Paulson incision following posterior cervico-dorsal arthrodesis.

Findings:

• Pathology confirmed a complete R0 resection, indicating no residual tumor.
• One year post-surgery, there is no local recurrence of the Pancoast tumor.
• Disease progression in the acetabulum necessitated further treatment including irradiation and iliac resection with prosthesis reconstruction.

Implications:

• En bloc vertebral resection is a viable and potentially curative option for Pancoast tumors with spinal invasion.
• Multidisciplinary management is crucial for optimizing outcomes in complex thoracic and spinal oncological cases.
• Long-term surveillance and management of metastatic disease are essential following aggressive primary tumor resection.