Bernadette Calabek1, Stefan Meng2, Sabine Pollanz1, Walter Klepetko3, Konrad Hoetzenecker3, Felicitas Oberndorfer4, Wolfgang Grisold1. 1. Department of Neurology, Kaiser Franz Josef-Hospital, Ludwig Boltzmann-Institute of Neurooncology, Vienna, Austria. 2. Department of Radiology, Kaiser Franz Josef-Hospital, Vienna, Austria. 3. Department of Thoracic Surgery, University Hospital of Vienna, Vienna, Austria. 4. Clinical Institute of Pathology, University Hospital of Vienna, Vienna, Austria.
Abstract
INTRODUCTION: The Pancoast syndrome (PS) has been termed after Henry Pancoast. Its neurologic core symptoms include pain, radicular sensory and motor syndromes, and Horner syndrome. A PS is often the presenting sign of lung cancer and bears a grim prognosis. METHODS: This case report describes an atypical onset of a lung tumor causing a PS. Electrophysiological examination was not conclusive. The diagnosis was confirmed by MRI, CT scan, and biopsy. The intervention consisted of preoperative chemo- and radiotherapy and was followed by an extensive surgical approach with histologically confirmed perineural invasion of the brachial plexus. RESULTS: The postoperative period was dominated by neuropathic pain. Despite considerable loss of distal sensorimotor function of the right hand, the patient uses the extremity and has returned to professional life. DISCUSSION: This observation triggered by the advances in general oncology and surgery also demonstrates the management of a lesion of the peripheral nervous system caused by cancer.
INTRODUCTION: The Pancoast syndrome (PS) has been termed after Henry Pancoast. Its neurologic core symptoms include pain, radicular sensory and motor syndromes, and Horner syndrome. A PS is often the presenting sign of lung cancer and bears a grim prognosis. METHODS: This case report describes an atypical onset of a lung tumor causing a PS. Electrophysiological examination was not conclusive. The diagnosis was confirmed by MRI, CT scan, and biopsy. The intervention consisted of preoperative chemo- and radiotherapy and was followed by an extensive surgical approach with histologically confirmed perineural invasion of the brachial plexus. RESULTS: The postoperative period was dominated by neuropathic pain. Despite considerable loss of distal sensorimotor function of the right hand, the patient uses the extremity and has returned to professional life. DISCUSSION: This observation triggered by the advances in general oncology and surgery also demonstrates the management of a lesion of the peripheral nervous system caused by cancer.
Authors: Cordula C M Pitz; Aart Brutel de la Rivière; Henry A van Swieten; Vincent A M Duurkens; Jan-Willem J Lammers; Jules M M van den Bosch Journal: Eur J Cardiothorac Surg Date: 2004-07 Impact factor: 4.191
Authors: K Okubo; H Wada; T Fukuse; H Yokomise; K Inui; O Ike; H Mizuno; M Aoki; S Hitomi Journal: Thorac Cardiovasc Surg Date: 1995-10 Impact factor: 1.827