Clinical Case of Pancoast Tumor Late Diagnosis

The article presents a clinical case that clearly illustrates the common manifestation of Pancoast tumor and emphasizes the need to maintain a high level of clinical concern for symptoms that may indicate this disease. Pancoast tumor (PT) is a malignant neoplasm of the lung upper sulcus of the lung, “superior sulcus tumor”, which is accompanied by tumor growth into the upper ribs, lower cervical vertebrae, neurovascular bundle, and other nearby anatomical areas and structures. This dangerous malignant disease manifests itself with characteristic symptoms, and its clinical signs include two main syndromes – Pancoast–Tobias syndrome (symptoms of brachial plexus damage) and Bernard–Horner syndrome (damage to the sympathetic nervous system – ptosis, miosis, enophthalmos). It is important to mention that sometimes a patient may experience both symptoms at the same time, but more often only one of them is detected. In addition, other signs characteristic of other cancer forms may be observed (loss of strength, unexplained weight loss). It is not yet clear what factors to the appearance and development of PT, but it is known that smoking is the main cause in approximately 80–85% of registered cases. The overall prognosis for patients with this disease is poor. The 5-year survival rate for this form of lung cancer is about 30%, in the case of early diagnosis and timely treatment, this index can increase to 75%. Treatment involves interdisciplinary care coordinated by a thoracic surgeon, radiation oncologist, and medical oncologist. The described clinical case emphasizes the importance of a carefully collected anamnesis, the appointment of necessary diagnostic methods, and meticulousness in conducting differential diagnosis and evaluating signs that may indicate a PT.