Pancoast’s Syndrome

•Bronchogenic carcinoma in the apex of the lung.
•Horner’s Syndrome: miosis, ptosis, enophthalmos and anhidrosis.
•Lower brachial plexus injury (C8-T1): Klumpke’s palsy.
•Paresthesia of the upper extremity due to compression of subclavian artery & vein.
•Shoulder pain: due to involvement of upper ribs and intercostal nerves.
•Respiratory effects.
The differential diagnoses of arm and shoulder pain are extensive; however, the primary conditions that must be excluded are thoracic outlet syndrome and cervical disk disease, which are commonly mistaken for Pancoast syndrome in the early clinical course. Careful neurologic examination, electromyographic studies, and ulnar nerve studies are performed to verify the precise diagnosis.
Diagram for Pancoast’s Syndrome.

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