Pancoast tumor pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overveiw
Pancoast tumor is the type of lung cancer that is associated with invasion of the apical chest wall. The location of Pancoast tumor in the superior sulcus results in an invasion of adjacent structures and in its characteristic clinical presentation. The progression of Pancoast tumor usually involves spread across the pleural apex to invade the following structures by direct extension into lymphatic vessels in the endothoracic fascia, intercostal nerves, lower roots of brachial plexus, stellate ganglion, sympathetic chain, adjacent ribs, adjacent vertebra bodies, extension to the spinal cord can result in cord compression, subclavian artery or subclavian vein. The development of Pancoast syndrome is the result of tumors in the superior pulmonary sulcus is characterized by pain along ulnar nerve distribution and Horner's syndrome.
Pathophysiology
- Pancoast tumor is the type of lung cancer that is associated with invasion of the apical chest wall. The location of Pancoast tumor in the superior sulcus results in an invasion of adjacent structures and in its characteristic clinical presentation.[1][2][3][4]
- The progression of Pancoast tumor usually involves spread across the pleural apex to invade the following structures by direct extension:
- Lymphatic vessels in the endothoracic fascia
- Intercostal nerves
- Lower roots of brachial plexus
- Stellate ganglion
- Sympathetic chain
- The first, second, or third rib
- First or second thoracic vertebra bodies or intervertebral foramina
- Extension to the spinal cord can result in cord compression
- Subclavian artery
- Subclavian vein
- The development of Pancoast syndrome is the result of tumors in the superior pulmonary sulcus is characterized by pain along ulnar nerve distribution and Horner's syndrome.
References
- ↑ Paulson DL (1975). "Carcinomas in the superior pulmonary sulcus". J. Thorac. Cardiovasc. Surg. 70 (6): 1095–104. PMID 1186286.
- ↑ Pitz CC, de la Rivière AB, van Swieten HA, Duurkens VA, Lammers JW, van den Bosch JM (2004). "Surgical treatment of Pancoast tumours". Eur J Cardiothorac Surg. 26 (1): 202–8. doi:10.1016/j.ejcts.2004.02.016. PMID 15201002.
- ↑ Glassman LR, Hyman K (2013). "Pancoast tumor: a modern perspective on an old problem". Curr Opin Pulm Med. 19 (4): 340–3. doi:10.1097/MCP.0b013e3283621b31. PMID 23702478.
- ↑ Panagopoulos N, Leivaditis V, Koletsis E, Prokakis C, Alexopoulos P, Baltayiannis N, Hatzimichalis A, Tsakiridis K, Zarogoulidis P, Zarogoulidis K, Katsikogiannis N, Kougioumtzi I, Machairiotis N, Tsiouda T, Kesisis G, Siminelakis S, Madesis A, Dougenis D (2014). "Pancoast tumors: characteristics and preoperative assessment". J Thorac Dis. 6 Suppl 1: S108–15. doi:10.3978/j.issn.2072-1439.2013.12.29. PMC 3966151. PMID 24672686.