pancoast tumour, DD of cervical spondylosis,

1. Pancoast Tumour
Vinod Naneria
Girish Yeotikar
Arjun Wadhwani
Choithram Hospital & Research Centre,
Indore, India

2. Eyes see only those things which mind
knows.

3. 60 Yrs Male 65 Yrs Male
Case One Case Two

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. Typical cervical spine MRI of case two

6. Missed the target by miles!
Have a look again

7. Second Rib on Right side missing Second Rib
Third Rib
Third Rib
First Rib First Rib
Case one

8. Mass Right apex eroding 2nd rib and vertebra

9. Opacity on left upper lobe
Case two

11. Pancoast Tumour
Pancoast tumours are named for Henry Pancoast,
a US radiologist, who described them in 1924 and
1932. It is also called a pulmonary sulcus tumour
or superior sulcus tumour.
It is a tumour of the pulmonary apex. It is a type
of lung cancer defined primarily by its location
situated at the top end of either the right or left
lung. It typically spreads to nearby tissues such as
the ribs and vertebrae. Most Pancoast tumors are
non-small cell cancers.

12. 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 patient's 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.

13. Typical Chest X-ray

14. DISCLAIMER
Information contained and transmitted by this presentation is
based on personal experience and collection of cases at
Choithram Hospital & Research centre, Indore, India, during
last 32 years. It is intended for use only by the students of
orthopaedic surgery. Views and opinion expressed in this
presentation are personal. Depending upon the x-rays and
clinical presentations viewers can make their own opinion.
For any confusion please contact the sole author for
clarification. Every body is allowed to copy or download and
use the material best suited to him. I am not responsible for
any controversies arise out of this presentation. There is no
direct or indirect involvement of finances in preparation of
this presentation. For any correction or suggestion please
contact naneria@yahoo.com