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Pancoast tumor presenting with multiple joint pains: a case report.
Safia Mohamud1, Mosunmola Oyawusi2, Roger L Weir2
1Department of Neurology, George Washington University Hospital, Washington, DC, 20037, USA. smohamud@gwu.edu.
Journal of Medical Case Reports
|March 16, 2022
Summary
Pancoast tumors, often missed on initial X-rays, can present as shoulder pain. Early diagnosis through comprehensive evaluation is key for better outcomes in these apical lung cancers.
Area of Science:
- Oncology
- Pulmonology
- Neurology
Background:
- Pancoast tumors are apical lung cancers that invade surrounding tissues.
- These tumors are often not visible on initial chest X-rays, leading to delayed diagnosis.
- Symptoms may arise only after significant invasion of adjacent structures.
Observation:
- A 58-year-old non-smoking male presented with chronic joint pain, shoulder pain radiating to the arm, and hand swelling.
- Initial MRI showed cervical spondylosis and a questionable apical mass.
- CT scan revealed a large right apical lung mass with chest wall invasion and rib erosion.
Findings:
- Biopsy confirmed poorly differentiated non-small cell lung cancer.
- Radiation therapy improved the patient's pain significantly.
- Chemotherapy was recommended but declined by the patient.
Implications:
- Pancoast tumors should be considered in the differential diagnosis for patients with shoulder pain and neurological symptoms.
- Early detection through thorough history and physical examination is vital.
- Prompt diagnosis and treatment can improve outcomes for patients with Pancoast tumors.